Thank you for choosing Bender Chiropractic Health & Vitality Center for your healthcare needs!

To complete your paperwork in the comfort of your home:
Simply click on the appropriate form, print, and fill it out!
OR Click on the Online option to fill it out electronically and submit.

To return your completed paperwork to us:
Fax it to (586) 296-5647 OR email it to lindsay@benderchiro.com
OR bring it to the office with you.

Please scroll down to choose the paperwork you need or choose your service here:

Click APPOINTMENTS to request an appointment or call the office at (586) 296-6242

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patient forms Clinton Twp., MI

Chiropractic

Nutrition Response Testing

BrainTap

Long-Covid Care

Neuro Emotional Technique

Foot Levelers

Decompression and Traction

Decompression and Traction is not an individual service. These treatments are used if our doctors recommend them as part of your care with Chiropractic treatment. Please click Chiropractic to complete the necessary paperwork for a Chiropractic new patient appointment.

NeuralChek

Neural Chek is not an individual service. It is used as part of our new patient evaluations for Chiropractic, Nutrition Response Testing and BrainTap. Please choose which of those services you are interested in to complete paperwork for your new patient appointment.

21-Day Detox

You do not have to be a patient to get a 21-Day Detox Kit! Feel free to call our office at (586) 296-6242 to request the flavors you want for your kit. If we don’t have it in stock, we can typically get it within a few days! If you want to continue your natural healthcare journey, please request a new patient appointment for Nutrition Response Testing!