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Practice Name

Fairless Hills Health Center

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Primary Location
81 Crabtree Drive & Levittown Parkway
Levittown, PA 19055
Phone: 215-949-3720
Fax: 215-949-1831

Office Hours

Day
Monday9:008:00
Tuesday4:008:00
Wednesday9:008:00
Thursday4:008:00
Friday9:008:00
Saturday
Sunday
Main Content

The FAIRLESS HILLS HEALTH CENTER offers our patient form(s) online so you can complete it in the convenience and comfort 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.

New Patient Case History Form - Required

This let's us know the history and current state of your health. It is required for all new patients, unless you were involved in an automobile accident or a work injury. If that is the case, you would need to fill out one of the forms below.

Download & Print Form


Personal Injury Questionnaire - Required if you were injured in an automobile accident

This let's us know the history and current state of your health. It contains all of the detailed information we will need regarding your specific automobile injury.

Download & Print Form


Work Comp History - Required if you were injured at work

This let's us know the history and current state of your health. It contains all of the detailed information we will need regarding your specific work injury.

Download & Print 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 office. You can print it out and bring it in to our office 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



Download the Free AdobeReader®

Testimonial

"Chiropractic care worked wonders on my migraines. I am no longer reliant on daily medications. The doctors and staff at the Fairless Hills Health Center are friendly, caring, and enthusiastic about their patients!"

Suellen M.

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Our services

We strive to provide complete care for our patients. Learn more about all the services we provide.

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Contact

Fairless Hills Health Center
81 Crabtree Drive & Levittown Parkway
Levittown, PA 19055
Get Directions
 
  • Phone: 215-949-3720
  • Fax: 215-949-1831
  • Email Us
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Office Hours

Day
Monday9:008:00
Tuesday4:008:00
Wednesday9:008:00
Thursday4:008:00
Friday9:008:00
Saturday
Sunday
Newsletter

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Community Content
Member Wellness