Online Forms

New Patient Forms - All Documents Required 

- Prior to your first visit, please download and print the documents below.

- Arrive 15 minutes prior to your appointment with your completed paperwork.

- If you do not already have AdobeReader® installed on your computer, click here to download.


New Patient Paperwork (4 pages)



Download the Free Adobe Reader®

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Testimonials

Reviews By Our Satisfied Patients

  • "Dr. Bencivengo came in & told me exactly what the problem was, how we were going to fix it & how to prevent it in the future. The care at 360 is EXCELLENT!"
  • "Knowing that whatever Dr. Bencivengo was doing made a difference in just a few minutes was very encouraging. Within 2 weeks, Dr. B had me pain free"
  • "360 Health Center is totally professional in all aspects of check-in, pre-treatment, treatment and check-out. The back adjustment and the explanations as to how things work so corrective actions can be taken by myself have helped me improve. I would most definitely recommend this facility to a family member."
    Joseph M.