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Lauterbach Chiropractic offers our patient form(s) online so they can be completed it in the convenience of your own home or 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!

Informed Consent Intake Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



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New patients receive a complementary 30 minute massage certificate
After any new patient chiropractic exam.

Sign-up using the form or call us at 434-591-0900 to take advantage of this exclusive offer.
Federal plans excluded

THIS ---->https://drlauterbach.chiromatrixbase.com/online-forms.html

Day
Monday8:30 - 12:002:00 - 6:00
Tuesday8:30 - 12:002:00 - 6:00
Wednesday8:30 - 12:002:00 - 6:00
Thursday8:30 - 12:002:00 - 6:00
Friday8:3012:00
Saturday9:00 - 11:00Closed
SundayClosedClosed
Day
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:30 - 12:00 8:30 - 12:00 8:30 - 12:00 8:30 - 12:00 8:30 9:00 - 11:00 Closed
2:00 - 6:00 2:00 - 6:00 2:00 - 6:00 2:00 - 6:00 12:00 Closed Closed

Dr. Lauterbach has helped me when the going gets tough! I have fibromyalgia and when I first saw him I couldn't raise my arm due to the tightness in my shoulder blade and back. He gave me my arm motion back. The massage therapy in his office is wonderful, too. He has helped my son with repeated back pain after an injury, as well. He and his staff are very professional and friendly and will always work you in. Can't recommend his services high enough!

Palmyra, VA

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