Terms of Use
By submitting this form you acknowledge that you understand that: (1) This form is submitted to Richards Family Chiropractic via email. (2) Communications via email over the internet are not secure. (3) There is a possibility that information you include in an email can be intercepted and read by other parties besides the person to whom it is addressed. (4) We request that you do not include personal identifying information in any emails you send to us. (5) Submitting this form will be considered to be an acknowledgment that you are aware of the possible risks of using unencrypted e-mail communications and that these risks are acceptable to you. (6) There are other options available to you for communicating with our office such as physical mail, phone, and fax. (7) No one can diagnose your condition from email or other written communications, and communication via email, or via our website cannot replace the relationship you have with a physician or another healthcare practitioner.