For your convenience we have attached a link below.  Please fill out and click submit. Otherwise, we suggest you arrive 15 minutes prior to your appointment to allow ample time for paperwork and insurance verification.  If you have any questions, please do not hesitate to contact us.

NEW PATIENT FORMS- CLICK ME

Or copy and paste this link below
https://intake.mychirotouch.com/?clientid=CC0066​

First Visit

Call today for an appointment, 
So We Can Keep You In Motion!

​704-587-0078

Dr. Jared Scholtisek
City Chiropractic 
14142 Rivergate Parkway, Suite 300
Charlotte, NC 28273
mycitychiro@gmail.com