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New Patient Forms

We have an electronic patient form that will allow you to enter all your medical information on a secure site that will transfer the information directly into our chiropractic software program.

The link will take you to a second site where you will see at fillable form that looks like the graphic to the right, and says Red Mill Chiropractic with our logo.

The form has different sections as you scroll down it. If you are filling out the form for your child, you will also need to fill out the pediatric specific section that starts about 1/2 of the way down the form.

If you have any questions while filling out the form, please contact our office at (757) 918.7761 so we may assist you with any questions you may have regarding the form.


When you come into out office for an appointment, you can expect prompt service! Our doctor and staff work hard to make sure every patient feels relaxed and at home when they walk through our doors. Since chiropractic care generally involves more than one visit, our team works to build trusting relationships with every patient. We believe the best way to have a successful patient relationship is to fully explain everything in advance. This way the patient knows exactly what their treatment is going to be and what it involves. The more the patient knows, the more they can relax when they come in for their appointment.



During your first visit you will receive an in depth:

  • Consultation with our doctor about what is concerning you

  • Thorough chiropractic, neurological, and orthopedic examination to help locate the cause of the problem

  • Full spine x-rays (as indicated)


If it is determined that chiropractic care is appropriate for your condition, you will then receive (or be scheduled for) your first treatment.


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