New patients · Canton, OH
Office forms
Download and print new patient forms for Belden Village Chiropractic and Wellness Center in Canton, OH before your first visit. Filling them out ahead of time can save time at check-in.
Before your first visit
Getting your paperwork done at home can save time at check-in.
- 1. Download and print Choose a form from the box above. It opens in a new tab so you can print it.
- 2. Fill it out at home Complete the clinic intake form with your personal, medical and health history information.
- 3. Bring it with you Bring your completed forms, insurance card and photo ID to your first visit.
- 4. Questions? Call 330-493-0009 and our team can help with your paperwork.
To protect your health information, please do not email completed forms.
Visit our Canton office
- Address
- 4200 Munson Street NW, Suite B, Canton, OH 44718
- Phone
- 330-493-0009
- Hours
- Mon–Thu: Dr. Ungar 7:45 a.m.–6 p.m.
Mon–Thu: Dr. Gatelaro 8 a.m.–6 p.m.
Fri–Sun: Closed - Parking
- [parking and entrance notes]
Patients visit us from Canton, North Canton and across Stark County.
Ready for your first visit?
Start with a full exam and a clear talk about your options. Call 330-493-0009 or send a request.