Request an Appointment

Family Chiropractic Health Center
4612 Plainfield NE
Grand Rapids, MI 49525
616-363-7713
info@familychiropracticmi.com
*Indicates a Required Field

Please view our office hours and then fill in the following form to request an appointment. You will receive a confirmation call to verify, before any appointment is scheduled.

*First Name
*Last Name
*Phone

Format XXX-XXX-XXXX
*Email Address


Date and Hour for Requested Appointment

*Select Hour *AM/PM

*Please tell us if you are a current patient, or are requesting to become a new patient.
I am a current patient at your office
I am looking to make an appointment to become a new patient


Optional Short Comments or Message



NOTE: You do not have a scheduled appointment until we can call you and verify this appointment request.

               

Monday
7 A.M. - 6 P.M.
Tuesday
7 A.M. - Noon & 4 P.M. - 7 P.M.
Wednesday
 7 A.M. - 6 P.M.
Thursday
 7 A.M. - Noon
Friday
 7 A.M. - 5 P.M.