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New Patient Paperwork

Back and Neck Pain Relief Center offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them...
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.
OFFICE HOURS
Monday9:00am - 12:00pm
2:00pm - 7:00pm
Tuesday8:00am - 1:00pm
Wednesday9:00am - 12:00pm
2:00pm - 7:00pm
Thursday9:00am - 12:00pm
2:00pm - 7:00pm
Friday8:00am - 1:00pm
SaturdayClosed
SundayClosed
Chiropractic Bloomington IN Back and Neck Pain Relief Center Logo

Back and Neck Pain Relief Center
1710 West 3rd Street
Bloomington, IN 47404
(812) 336-2225
Fax: (812) 822-0606
backandneckpainreliefcenter@gmail.com

Recommended Chiropractor

WHAT OUR PATIENTS SAY

“Dr. Fox’s staff is incredibly friendly and helpful. They provide a very welcoming and social atmosphere during treatment as well as effective care. Dr. Fox goes to great lengths to help you understand what he's doing as well as help you to take steps toward your overall wellness.”

- Dillon Gross

“I wish everyone would come to Dr Fox and experience the healing. I just feel so much more Alive! I feel 20 years younger, my pain is nearly gone which I’ve had for years, I think clearer, I sleep better, I even breathe better. I can do more and my life is happier.”

- Kathleen Zellers

“Dr Fox has been the most helpful heath practitioner I have ever had, he is very gentle, reassuring and his willingness to explain his procedures has made me very comfortable. My experience has been overwhelmingly positive.”

- Brandi Masterson

Recommended Chiropractor - White

1710 West 3rd Street

Bloomington, IN 47404