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Patient Forms

Before recommending a specific treatment, the staff members of Vitality Chiropractic Wellness Inc. in Los Alamitos, California will conduct a full assessment of your health, which includes examining your medical history, lifestyle, and eating habits. Kindly fill out the form below with your personal data.



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Important Reminders 

If insured, an insurance card and driver’s license will be required on the first visit so we may verify your benefits and eligibility on your behalf. If you are not insured, don't let that stop you! We don't want finances to stop you from getting the care you need.

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