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Online Forms

Dr. Jack V. Waters D.C. P.C. offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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.

New Patient Health History Form - Required

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

"Forms will be available when you come to our office"

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Office Hours

Our Regular Schedule

Dr. Jack V. Waters D.C. P.C.


8:00 am-12:00 pm

1:30 pm-5:00 pm


8:00 am-12:00 pm

1:30 pm-5:00 pm


8:00 am-12:00 pm

1:30 pm-5:00 pm


8:00 am-12:00 pm

1:30 pm-5:00 pm


8:00 am-12:00 pm


By Appt.




  • "Dr. Waters is amazing! I have only been seeing him for a few days, but I can already tell a difference. He is so friendly and definitely knows what he is doing. He has also adjusted my children and I have seen a change in them too. Thanks, Dr. Jack."
    Shanin F.