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Wall Street Chiropractic and Wellness 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.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form


Toxicity Questionnaire

Download & Print Form


Symptom Survey

Download & Print Form



Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our chiropractic office. You can print the form out and bring it in to our office during your next visit with our chiropractor, or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



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Request An Appointment

Please complete the following form to request an appointment. Please note that availability will vary depending on your request. Your appointment will be confirmed by phone from a member of our staff.



 

Top Chiropractors in New York, NY
Congratulations to Dr. Charles V. Nicolai, DC for winning the 2015 Patients' Choice Awards in New York Chiropractic
Verified by

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Office Hours

DayMorningAfternoon
Monday7am-2pm4pm -7pm
Tuesday7am-2pm3pm -7pm
Wednesday7am-2pm3pm -7pm
Thursday7am-2pm3pm -7pm
Friday7am-2pm3pm -7pm
Saturdayby Appt.by Appt.
Sundayby Appt.by Appt.
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
7am-2pm 7am-2pm 7am-2pm 7am-2pm 7am-2pm by Appt. by Appt.
4pm -7pm 3pm -7pm 3pm -7pm 3pm -7pm 3pm -7pm by Appt. by Appt.

Testimonial

Can't say enough about my experience with Dr. Nicolai. Not only is he technically brilliant, Dr. Nicolai creates a warm, personal experience that is unmatched. Definitely worth traveling to if you don't live or work in the Financial District. Your body will thank you.

Charles P
New York, NY

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