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Practice Name

Forever Young Chiropractic

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Primary Location
138 Eastbrooke Court, Suite 130
Mt. Washington, KY 40047
Phone: 502-538-0222
Fax: 502-538-0282

Office Hours

Day
Monday6:30am6:00pm
Tuesday1:00pm6:00pm
Wednesday6:30am6:00pm
Thursday6:30am6:00pm
Friday6:30am12:00pm
SaturdayClosedClosed
SundayClosedClosed
Main Content

Forever Young Chiropractic offers our patient form(s) online so they can be completed 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!

Download & Print Form


Re-Activation Forms 

Print these off, fill them out and bring them with you to your "Re-Exam" appointment.

Re-Activation Form


Authorization for the Release Form

Download & Print Form


Accident/Injury Form

Download & Print 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



Download the Free AdobeReader®

Exclusive Offer

Always Accepting New Patients!

Sign-up using the form or call us at 502-538-0222

Name: *
Email: *
Phone: *

Our Services

We strive to provide complete care for our patients. Learn more about all the services we provide.

View Services

Office Hours

Day
Monday6:30am6:00pm
Tuesday1:00pm6:00pm
Wednesday6:30am6:00pm
Thursday6:30am6:00pm
Friday6:30am12:00pm
SaturdayClosedClosed
SundayClosedClosed

Request Appointment

502-538-0222

Contact

Forever Young Chiropractic
138 Eastbrooke Court, Suite 130
Mt. Washington, KY 40047
Get Directions
  • Phone: 502-538-0222
  • Fax: 502-538-0282
  • Email Us
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Community Content
Member Wellness