Excelsior Health Center
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    • Emotional Balancing
  • Your Doctor
  • What to Expect
  • New Clients
    • Start Here
    • FAQ
    • New Client Form
  • Schedule Appointment
  • Contact
  • Home
  • Services
    • All Services
    • NES Nutri Energetic Systems
    • Traditional Chiropractic
    • Frequency Treatments
    • Allergy Elimination Technique
    • Brain Balancing
    • Detoxification
    • Emotional Balancing
  • Your Doctor
  • What to Expect
  • New Clients
    • Start Here
    • FAQ
    • New Client Form
  • Schedule Appointment
  • Contact

New Client Form

Please start by clicking the "New Client Form" button below.

​DOWNLOAD IT TO YOUR COMPUTER BEFORE FILLING IT OUT.
PLEASE MAKE SURE ALL FIELDS ARE FILLED OUT AND SAVED BEFORE EMAILING IT BACK TO US.
 


Find the file on your computer, open it and then fill it out. Save the changes. Then you can upload it using the form to the right or email it to: cschiro61@comcast.net

​You can also print it and save it for your records or bring it in to your next appointment.

OPEN AND DOWNLOAD FORM:
NEW CLIENT FORM

    Submit New Client Form Here

    Max file size: 20MB
    Please find the "New Client Form" pdf file that you saved to your computer and upload it here. Once it is uploaded, hit the submit button and we will receive it. Don't forget to fill out your name, email and phone number and leave us any comments if you need to. Thanks!
Submit
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© Copyright 2017 | Excelsior Health Center

The power that made the body heals the body.

We offer an array of holistic services to help people achieve their optimum health.

Contact Us

1255 Lake Plaza Drive  Suite 140
Colorado Springs, CO  80906
(719) 502-6323 Dr. Reeves

Email us