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Charlene A. Canali, DC PA 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.


Downloadable PDF Forms (Complete & Print)

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!

New Patient Chiropractic Registration & History Form
Financial Policy Form
HIPPAA Form

For Nutritional Consultation Only
English Symptom Survey Form
Spanish Symptom Survey 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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CALL or TEXT 

305-284-7223


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THIS ---->https://drcharlenecanalicom.chiromatrixbase.com/online-forms.html

Office Hours

DayOpenClose
Monday8:306:00
Tuesday8:301:00
Wednesday8:307:00
ThursdayClosedClosed
Friday8:305:00
SaturdayClosedClosed
SundayClosedClosed
Day Open Close
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:30 8:30 8:30 Closed 8:30 Closed Closed
6:00 1:00 7:00 Closed 5:00 Closed Closed

Testimonial

I have been seeing Dr. Charlene Canali for over two years, and what an amazing doctor she is!  Because of the results I have received, I have referred over 20 patients to her, and will continue to do so.

I am convinced that we, as a society, take more prescription drugs than ever and instead of curing diseases, they camouflage them.  Natural medicine, acupuncture and chiropractic medicine work when you combine them with the intelligence, care and compassion of Dr. Canali.  
 

Toni P
South Miami, FL

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