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Online Forms

Back in Line Chiropractic Center offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Our forms may be completed on your computer and then printed, or the blank forms may be printed and filled out by hand.
  • Compete the necessary forms with all information requested and print them.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Forms - Required

These forms will help us to know the history and current state of your health.  If you have questions or concerns about your wellness, please let us know.  We would also welcome the opportunity to help you set and reach your goals.

Patients Involved in Accidents

These forms are necessary to assist us in your individualized treatment and recovery.

 Medicare Patients 

 These forms are necessary to assist us in your individualized treatment and recovery. 

Notice of Privacy Practices

Nondiscrimination and Accessibility Notice here

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Please feel free to browse Our website for more information about Back In Line Chiropractic Center in Plantation, Florida. If you have any questions or would like to schedule an appointment we can be reached by calling 954-584-BACK (2225) or use our .


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Review By Our Satisfied Patient

  • ""Due to Back In Line Chiropractic Center, my body has made a tremendous jump. Before coming here I had a few ailments that have been improved or taken care of. It is a pleasure to be treated by Dr. Peter and Dr. Barbara Marciante"

    Ronnie Brown- NFL Running Back and second overall pick in the 2005 NFL draft by the Miami Dolphins"