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Empowered Life, PC 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.

Practice Member Intake Information:

To save some time on your first visit, print and fill out the following Practice Member Intake Form.

You may print and fill out or you may download and open in AdobeReader and auto-fill out electronically and either e-mail or print and bring in the form completed.  E-mail to frontdesk@EmpoweredLifeChiropractic.com

Adult Intake Form

Pregnancy Intake Form

Infant & Toddler Intake From

School Aged Intake Form



Download the Free AdobeReader®

Exclusive Offer

New patients receive 15% OFF first visit.

Sign-up using the form or call us at 912-826-3482 to take advantage of this exclusive offer.

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

Office Hours

DayMorningAfternoon
Monday9am5:30pm
TuesdayBy Appointment Only - Nutrition
Wednesday9am6:00pm
ThursdayClosedClosed
Friday9am5:00pm
SaturdayEvery Other by Appointment Only
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9am By Appointment Only - Nutrition 9am Closed 9am Every Other by Appointment Only Closed
5:30pm 6:00pm Closed 5:00pm Closed

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