New Patient Paperwork

Perry Chiropractic & Therapy offers our patient form(s) online so they can be completed 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 them with you to your appointment.


9:00am - 12:00pm
2:00pm - 6:00pm

9:00am - 12:00pm
2:00pm - 6:00pm

9:00am - 12:00pm
2:00pm - 6:00pm

9:00am - 12:00pm
2:00pm - 6:00pm

By Appointment

Perry Chiropractic & Therapy
4933 West Tuscarawas Street
Canton, OH 44708
(330) 477-3036

"You may not control all the events that happen to you, but you can decide not to be reduced by them. If you cannot make a change, change the way you have been thinking. You might find a new solution."

Maya Angelou