Patient Form

For your convenience, you may complete the form below before your first appointment. Please bring your ID (drivers license, state ID) and insurance card if you plan to use insurance. You will also be required to sign a consent form before treatment. Thank you!


Feel free to call 419-300-2225 or email with any questions.

Find us:

No Appointment Necessary

Walk-ins Always Welcome!

Monday - Thursday:  9am - 12pm & 2pm - 6pm

Friday:  9am - 12pm

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134 W. Spring Street

St. Marys, Ohio 45885

Tel: 419-300-BACK (2225)

Fax: 419-300-NECK (6325)