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Patient Forms

South Orange Chiropractic Center offers our patient forms online so you can complete them in the convenience of your own home or office.

If you do not already have AdobeReader® installed on your computer, click here to download.
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. Our fax number is (973) 761-1546.
If you have questions, feel free to contact us directly.

Welcome Forms - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding your wellness can we help you with? Let us know!

Download & Print Form

Personal Injury Questionnaire

Download & Print Form

Download the free AdobeReader®

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Welcome Message from Dr. Levine and Dr. Roczey

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ProAdjuster

ProAdjuster Technology has a sensor that assists the doctors with analyzing, treating and adjusting the spine and restoring nerve function loss.

Learn more...

Thermal Imaging

How do you know your treatments are working?

The Insight Millennium thermal scanner will evaluate, with detail, where your spine is in distress and detecting areas of nerve disturbance.

At South Orange Chiropractic, we want the best results possible for patients like you and thermal imaging shows us your progress throughout your treatment even when you are pain-free.

Ask about this painless test at your next visit

Complete Evaluation

You'll receive a complete and comprehensive orthopedic, neurological, and chiropractic evaluation.

Request an appointment today

Stabilizing Orthotics

As an adjunct to chiropractic care, custom orthotics are made to fit your unique needs. This will help to support and correct areas of weakness allowing for improved spinal function.

For more information, see our Toolbox or ask us at your next visit.

On-site Xray

Digital x-rays, done with digital imagery, allow us the opportunity to rule out abnormalities that may need a referral and to observe the structural deficiencies and abnormalities that may exist.

Your care at South Orange Chiropractic is customized based on your comprehensive exam and test results including digital x-rays.

This holistic approach allows us to tailor our treatment protocols and to prescribe specific exercises to help you feel better sooner.

Ask about it at your next appointment.

Custom Education

Because your condition and situation are unique, you'll receive customized education on spinal stabilization, exercises, strengthening and prevention.

Request an appointment today