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Burak Chiropractic 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.

  • 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.

 Welcome Form     

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       Fill out online and print    

or

New Patient Health History Form

Download & Print Form        Fill out online and print


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 chiropractic office. You can print the form out and bring it in to our office during your next visit with our chiropractor, 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®

Call 570-422-1446 to make your appointment.

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

Office Hours

DayMorningAfternoon
Monday9:00am7:00pm
Tuesday9:00am7:00pm
Wednesday9:00am7:00pm
ThursdayClosedClosed
Friday9:00am6:00pm
Saturday9:00am12:00pm
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9:00am 9:00am 9:00am Closed 9:00am 9:00am Closed
7:00pm 7:00pm 7:00pm Closed 6:00pm 12:00pm Closed

Testimonial

Dr. Burak and his staff are professional, polite, and truly care more about their patients than they do the 'ol mighty dollar. He helped me tremendously before my deployment to Afghanistan, and I still feel good months later. He's one of those "fix the problem" Dr's, not one of those "lets just hide the pain for a while" Dr's. A great, great guy who knows his stuff!

Deployed Soldier
East Stroudsburg, PA

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