Online Forms

Patient Forms

Activate Chiropractic A Family Wellness Center 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.

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

Accident Intake Form

Should you be seeking care following an auto accident, please complete this form with as much information as you can.  We know this can be an overwhelming time so if you have any questions give us a call and we can talk you through it!

Download & Print Form

Pediatric Intake Form

We want to know the background of even our youngest patients.  To be completed by the parent or guardian of anyone up to age 18.

Download & Print Form

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.

Download the Free AdobeReader®

$77 First Visit for New Patients!

Includes detailed exam, neurological scans and a report of our findings

Office Hours

Our Regular Schedule


8:30 am-12:00 pm

2:00 pm-6:00 pm


8:30 am-12:00 pm

2:00 pm-5:00 pm


8:30 am-12:00 pm

2:00 pm-6:00 pm




8:30 am-12:00 pm

2:00 pm-6:00 pm






Find us on the map


Reviews By Our Satisfied Patients

  • "Dr. Libby has a great touch and has helped to greatly reduce my lower back and hip pain. With regular adjustments I have noticed a huge difference in my ability to be more active while staying pain free."
    Mary E. / Poway, CA

Featured Articles

Read about interesting topics

Newsletter Sign Up