Online Forms

Riverbend Chiropractic 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



Download the Free AdobeReader®

Walk-Ins Welcome/Be Seen Today/No Referral Needed
Our Goal Is To Get You Out Of Pain As Quickly As Possible

Dr. Roussel Is The Highest-Trained Whiplash and Brain Injury Traumatology Physician In The River Parishes (Advanced Certification By The Spine Research Institute of San Diego)

Exclusive Offer: Free Consultation, Including X-Ray/MRI Review ($100 Value)

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ChiroTrust® Member Chiropractor
Destrehan, LA 70047 Chiro-Trust.org

EXCLUSIVE OFFER: ONLINE SCHEDULING AVAILABLE. SIGN UP USING THE FORM BELOW, OR CALL (985) 307-0977 TO MAKE AN APPOINTMENT AND RECEIVE TREATMENT TODAY. PHONE ANSWERED LIVE 24 HRS., 7 DAYS.

DR. ADAM ROUSSEL IS AN IN-NETWORK PROVIDER WITH MOST HEALTH INSURANCE PLANS. CAR INSURANCE IS ALSO ACCEPTED.

Locations

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HOURS OF OPERATION

Monday

8:00am-12:00pm

2:00-5:30pm

Tuesday

Closed

Wednesday

8:00am-12:00pm

2:00-5:30pm

Thursday

Closed

Friday

8:00am-1:00pm

Saturday

Closed

Closed

Sunday

Closed

Closed

Monday
8:00am-12:00pm 2:00-5:30pm
Tuesday
Closed
Wednesday
8:00am-12:00pm 2:00-5:30pm
Thursday
Closed
Friday
8:00am-1:00pm
Saturday
Closed Closed
Sunday
Closed Closed