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Online Forms

Piedmont Health Solutions 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!

Download & Print Form


Health Assessment Form

Download & Print Form


Metabolic Form

Download & Print Form


Food Test Intake Form

Download & Print Form



Download the Free AdobeReader®

Location

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Office Hours

Our Regular Schedule

Charlotte Office

Monday:

Closed

Tuesday:

Closed

Wednesday:

8:00 am-1:00 pm

2:00 pm-6:00 pm

Thursday:

Closed

Friday:

8:30 am-1:00 pm

2:00 pm-6:00 pm

Saturday:

9:00 am-12:00 pm

Sunday:

Closed

Testimonial

  • "I had a disk injury in my neck along with fibromyalgia. I had lower back surgery that was not successful and knew that was not something that I wanted to do again. I was looking for something better. Dr. Geada has helped me to start reaching my goals of having more good days than bad. I know that I will always battle fibro but since starting treatment I finally have hope."
    -A. Rollings