3350 North Hayden Road #112

Scottsdale, AZ 85251 US

(480) 994-4411

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Online Forms

Secrest Family Chiropractic, PC offers our patient form(s) online so you can complete it in the convenience of your own home or 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.                       Fax: 480-994-4421

"I want to be your Chiropractor!"

Dr. Daniel P. Secrest, DC  Chiropractic Physician

Note: As with any healthcare treatment/therapy, results are not guaranteed and there are no promises or claims made by the doctor, office staff or the corporation for the cure of any disorder, disease or condition. Chiropractic adjustments and supportive therapies are designed to reduce and/or correct subluxations, allowing the body to return to improved health. 

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


Lower Back Pain and Disability Questionnaire

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Neck Pain and Disability Index

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General Office Policies

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HIPPA Privacy Policies

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New Patients Receive a Complimentary Consultation

Our Specialties


Applied Kinesiology (KST)

Massage Therapy

Kinesiology Taping

Pregnancy

Office Hours

Monday:

7:00 am-7:00 pm

Tuesday:

7:00 am-7:00 pm

Wednesday:

By Appt

Thursday:

7:00 am-7:00 pm

Friday:

7:00 am-6:00 pm

Saturday:

Closed

Sunday:

Closed

Location

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Client Testimonial

  • "Dr Secrest really cares about his patients. He resolved a 3 year headaches issue for one of my sons that all the other doctors couldn't and he's been fantastic working with my son with autism."
    Click Here for more Testimonials

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