Bellevue Eastside Family Chiropractic & Wellness offers patient forms online so you can complete it in the convenience of your own home or office. You can submit forms in one of two ways: Online submission or Download & Print Forms.
Option 1 Online Submission:
Step One: Please Click Here to read Eastside Family Chiropractic & Wellness Disclosure form.
Step Two: Please Click Here to submit forms online.
Option 2 Download & Print Forms:
If you do not already have AdobeReader® installed on your computer, Click Here to download.
- Download and print the necessary forms and fill in the required information.
- Bring in your completed forms to your appointment, e-mail it to info@eastsidefamilychiropractic.com, or fax it to 425-688-1990.
Patient Forms-Required
Metabolic Assessment Form-Naturopathic Patient Only
Member Wellness Registration Form - Optional
Fill out this form to register for access to the Member Wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues, news, and events in our office. Print the form and bring it in to the office on your next visit or Click Here to register online. We look forward to making your experience with our office and website more interactive and rewarding one!
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Testimonials
"Best Chiropractor ever. He spends the time to explain and teach me exercises and correct postures for my daily activities."
Kelly, Bellevue
"The massage therapist’s deep tissue and stretching helped my frozen shoulder. I used to not be able to lift my arm higher than my chest level. Now I am back on my crossfit training."
Chris, Kirkland
"Dr. Leslie was so great that I brought my 3 kids and husband to see her for food allergies. She has helped my son’s ADHD problem and now teachers are telling me how much he has improved!"
Serena, Bellevue
Community Content
| Day | Open | Closed |
|---|---|---|
| Monday | 9:00 | 7:00 |
| Tuesday | Closed | Closed |
| Wednesday | 9:00 | 7:00 |
| Thursday | Closed | Closed |
| Friday | 9:00 | 7:00 |
| Saturday | 9:00 | 1:00 |
| Sunday | Closed | Closed |
Call Us:
425-688-1994 Request
Appt.
Contact
555 116th Avenue, N.E. Suite 116
Bellevue, WA 98004
Get Directions
- Phone: 425-688-1994
- Fax: 425-688-1990
- Email Us