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Practice Name

A Better Life Chiropractic

Primary Location
661 GOODLETTE ROAD NORTH STE108
NAPLES, FL 34102
Phone: 239-263-3369
Fax: 239-263-8842

Office Hours

DayMorningAfternoon
Monday8:30 - 10:303:30 - 6:00
TuesdayBy appt.3:30 - 6:00
Wednesday8:30 - 10:303:30 - 6:00
Thursday8:30 - 10:303:30 - 6:00
FridayBy appt.By appt.
SaturdayClosedClosed
SundayClosedClosed
Main Content

A Better Life Chiropractic 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.

Please print and complete the new patient forms below. Once complete, you may fax all pages to: (239) 263-8842. For your identity protection do not submit new patient forms via email.

New Patient Without Insurance:

Adult New Patient Form
Child New Patient Form

New Patients With Insurance:

Adult With Medical Insurance
Child With Medical Insurance

New Patient With Auto Accident Insurance:

Patient with Auto Accident Insurance

Records Release Forms:

Assignment of Benefits

Release of Records to ABLC

Release of Records from ABLC

(SE HABLA ESPANOL)



Click here to read our PRIVACY NOTICE

Exclusive Offer

NEW PATIENT
WEB OFFER: $95.00
CONSULTATION,
EXAMINATION & X-RAYS

Includes followup visit: Dr's Report & Review of X-Rays. Does not include Chiropractic Adjustment. Mention the website offer to receive your new patient visit for a reduced price of $95.00 or your insurance copay (A Value of $220.00).

Sign-up using the form or call us at 239-263-3369 to take advantage of this exclusive offer.

Name: *
Email: *
Phone: *

Other services are offered at our usual and customary fees. The patient and any other person responsible for payment has a right to refuse to pay, cancel payment, or be reimbursed for payment for any other service, examination or treatment which is performed as a result of and within 72 hours of responding to the advertisement for the free service, examination or treatment. Insurance billing not applicable to web offer.


 

Launch
3D Spine Simulator

Testimonial

What condition first brought you to our office? My balance, neck, back and shoulders

What treatments did you first try? Medication, physical therapy

How have you benefited from Chiropractic care? I now walk straight, free of lower back pain...more

Lori S. -
NAPLES, FL


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Our Services

We strive to provide complete care for our patients. Learn more about all the services we provide.

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Contact

A Better Life Chiropractic
661 GOODLETTE ROAD NORTH STE108
NAPLES, FL 34102
Get Directions
 
  • Phone: 239-263-3369
  • Fax: 239-263-8842
  • Email Us
From:  To:  Get Directions
Driving Directions: Reverse Directions Print Directions

Office Hours

DayMorningAfternoon
Monday8:30 - 10:303:30 - 6:00
TuesdayBy appt.3:30 - 6:00
Wednesday8:30 - 10:303:30 - 6:00
Thursday8:30 - 10:303:30 - 6:00
FridayBy appt.By appt.
SaturdayClosedClosed
SundayClosedClosed
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