Family Chiropractic and Nutrition Family Chiropractic and Nutrition
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  • Meet The Practitioners
  • Functional Medicine
  • Nutrition
  • Chiropractic Care
  • Services
    • 28 Day Purification Programs
    • Chiropractic Care
    • Lending Library
    • Mini- Health Food Store
    • Nutritional Analysis
    • Nutritional supplements
  • Purification
  • New Patient Forms
  • Contact Us

New Patient Forms

Please print and complete the following forms and bring to your initial appointment.

Nutrition Schedule

Cause Form

Wellness Actions

New Patient Information

Permission and Authorization

HIPAA Notice 1-2017

The following HIPAA information is available for your perusal.  We will provide you with a paper copy upon request.

HIPAA Booklet – 10-16-13.pdf

Order Standard Process Here

Contact Us

Family Chiropractic & Nutrition
Barbara Mitchem, DC, ACN

1123 Fannin St.
P. O. Box 627
Columbus, TX 78934
email: familychironutrition@yahoo.com
979-733-9500

Recent Posts

  • The Power That Made the Body Heals the Body
  • Inflammatory Bowel Disease and Red Dye
  • Questioning Statins’ Efficacy
  • Blood Pressure Medications and Nutrient Deficiencies
  • My Biggest Fear

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