Request an Appointment

Use the form below to request an appointment. Someone will respond to your message as soon as possible. If the office is closed at the time of your request, someone will respond once we reopen. Most appointments are accepted as requested. Do not use this form to request an appointment outside of our normal office hours:

  • Mon
  • 8:30 – noon
    2:30 – 5:30
  • Tue
  • Closed AM
    2:30 – 5:30
  • Wed
  • 8:30 – noon
    2:30 – 5:30
  • Thu
  • 8:30 – noon
    2:30 – 5:30
  • Fri
  • 8:30 – noon
    Closed PM
1 Step 1
First and Last Name
Phone
I am a
Notice to New Patients:
We take a little extra time for your first visit consultation and exam. In order to do this we can not accept New Patient appointments after 5 PM.
Date of Birth
0 /

Select date plus your first and second choice appointment times.
*Closed: Tuesday mornings & Friday afternoon

Date
First Choice
Second Choice
1st Choice
2nd Choice
Confirm my appointment by
Would you like to add a message to your request?
Additional Information
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Submission of this form acknowledges agreement to the Terms of Use.

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.

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