Online Forms

Bi-County Chiropractic Health Service offers our patient form(s) online so they can be completed it 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


Location of Discomfort


Download & Print Form


Discuss File

Download & Print Form


Notice of Privacy Practices and Patient Consent for Use and Disclosure of


Download & Print Form


Patient Introduction Form



Download & Print Form


Preferred Method of Contact



Download & Print Form


Work Auto Related


Download & Print Form




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Office Hours

Our Regular Schedule

Monday:

Dr. D'Agostino 8:00 a.m. - NOON

Dr. Hilborn 8:00 a.m. - NOON & 2:00 - 6:00

Tuesday:

Dr. D'Agostino 8:00 a.m. - NOON

Dr. Hilborn OFF

Wednesday:

Dr. D'Agostino 8:00 a.m. - NOON & 2:00 - 6:00

Dr. Hilborn 8:00 a.m. - NOON & 2:00 - 6:00

Thursday:

OFFICE IS CLOSED

OFFICE IS CLOSED

Friday:

Dr. D'Agostino 8:00 a.m. - NOON

Dr. Hilborn 8:00 a.m. - NOON

Saturday:

Dr. D'Agostino 8:00 a.m. - NOON

Dr. Hilborn 8:00 a.m. - NOON

Sunday:

OFFICE IS CLOSED

OFFICE IS CLOSED

Location

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Testimonials

Reviews By Our Satisfied Patients

  • "I was not going to go to a chiropractor! My medical doctor tried some therapy and drugs, but my left lower back and leg continued to hurt. After a few weeks I was surprised that my medical doctor referred me to Bicounty Chiropractic. Now my pain that I have had for 4 months is almost completely gone!"
    Laura L.

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