East Palestine Location

(330) 426-2700

Salem Location

(234) 567-4200

Chiropractic Care

Dailey Chiropractic, Inc 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!

Contact Us

Visit our Office

Hours of Operation

Monday  

9:00 am - 6:00 pm

Tuesday  

9:00 am - 1:00 pm

Wednesday  

3:00 pm - 8:00 pm

Thursday  

9:00 am - 1:00 pm

Friday  

Closed

Saturday  

Closed

Sunday  

Closed