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Forms

To access any form click the PDF Icon above the

descriptions for each file

No fault

Patient Forms

Consent To Treat

A Minor Forms

Financial &

No Show Policy

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New Patient

Intake Form​​

3140 Sheridan Drive, Suite 140, Amherst NY 14226

Tel: 716-240-9365

For Life-Threatening Emergencies Call 911

Email: bialeckichiropracticoffice@gmail,com

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