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Back and Wellness Clinic offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

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!

Please click on the link below to begin:


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

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Exclusive Offer

Free Initial Consultation

Sign-up using the form or call us at 408-979-9559 to take advantage of this exclusive offer.

THIS ---->https://drdaroodi.com/new-patient-center/online-forms.html

Office Hours

SaturdayBy appointment
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9:00am 9:00am 9:00am 9:00am 9:00am By appointment Closed
5:00pm 5:00pm 5:00pm 5:00pm 5:00pm


The best Chiropractic office I have ever been to. Great Doctor and Staff.

Kaum R.
San Jose, CA

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