Crystalign Chiropractic Covid-19 Chiropractic Care Financial Relief Application
At Crystalign Chiropractic we care deeply about the health and wellness of our patients and community. We recognize that many people have been affected financially by the pandemic and may not have been able to receive the care that they needed during this time. Crystalign Chiropractic is offering a limited number of visits per month to assist those who would otherwise be unable to receive the chiropractic care they need.

Please complete this short form to apply for sliding scale chiropractic care
Email *
Name *
Best Phone Number *
Please let us know the best way to contact you...
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Are you? *
Please share in your own words how Covid-19 has effected your ability to obtain chiropractic care since March 2020 (In about 150 words or so...) *
Please tell us what you are able to offer as payment? (Regular new patient fee $225 includes 2 visits and $45 per adjustment) *
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This form was created inside of Crystalign Chiropractic.