Request an Appointment

Desing Family Chiropractic
140 North Ocean Avenue
Patchogue, NY 11772
631-654-2225
drbrett@desingchiro.com
*Indicates a Required Field

Please view our office hours and then fill in the following form to request an appointment. You will receive a confirmation call to verify, before any appointment is scheduled.

*First Name
*Last Name
*Phone

Format XXX-XXX-XXXX
*Email Address


Date and Hour for Requested Appointment

*Select Hour *AM/PM

*Please tell us if you are a current patient, or are requesting to become a new patient.
I am a current patient at your office
I am looking to make an appointment to become a new patient


Optional Short Comments or Message



NOTE: You do not have a scheduled appointment until we can call you and verify this appointment request.

               

Monday
9:30 - 12:30, 3:00 - 6:30
Tuesday
3:00 - 6:30
Wednesday
 9:30 - 12:30, 3:00 - 6:30
Thursday
 3:00 - 6:30
Friday
 9:30 - 12:30, 3:00 - 6:30
Saturday
Closed
Sunday
Closed

Call for an appointment today!
631-654-2225