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Dr Butera
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Butera Chiropractic: Patient Forms

You can save time on your first visit by printing and completing the New Patient Intake Form. The information in the form is confidential, Dr. Butera will use this information to help formulate recommendations for your care.

To download the form, right-click (Control+click for Mac) on the link and select "Save Link Target As" or "Save Target As", depending on your browser.

adobe icon New Patient Intake Form

The form is a PDF document file. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

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