Patient Forms

Rockville Family Chiropractic Clinic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive at our chiropractic office.

  • If you do not already have AdobeReader┬« installed on your computer, click here to download the program.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

If you are unable to download and fill out these forms prior to your first appointment, please arrive 20 minutes before your first scheduled appointment.

New Patient Application Health Form - Required

This lets us know the history and current state of your health. Let us know if you have any questions, concerns, and goals regarding your condition.

Click here to download and print the form.

What we offer

Conditions We Treat & Services We Offer

Location

Our clinic is conveniently located 2 blocks north of the White Flint Metro (Red Line). It is very close to the intersection of Rockville Pike and Montrose road/Randolph road. Our staff speaks English, Spanish, Korean, and Chinese (Mandarin and Cantonese).

Parking

There is ample parking available at our building. For longer visits, please use the underground lot, entrance located behind the building. We validate the parking ticket. For 30 minutes or less, there are spots along the side of the building.

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Therapeutic Treatments We Offer

Rockville Family Chiropractic Clinic specializes in the following treatments:

  • Chiropractic Adjustment
  • Physical Therapy
  • Spinal Decompression
  • Postural Correction
  • Trigger Point Therapy
  • Myofacial Release Therapy
  • Ultrasound
  • Electric Muscle Stimulation
  • Therapeutic Taping
  • Therapeutic Exercises
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Location
Rockville Family Chiropractic Clinic
11921 Rockville Pike, Suite 411
Rockville, MD 20852
Phone: 301-304-6627
Fax: 301-881-3205
Office Hours

Get in touch

301-304-6627