Request an Appointment

Eagle's Touch Chiropractic & Wellness, PC
150 Broad Hollow Road, Suite 108
Melville, NY 11747
631-385-1400
info@theeaglestouch.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

For verification purposes, please type in the numbers and letters that you see below then press the Send Request button.

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

               

Monday
11:00 AM - 2:00 PM  
5:00 PM - 7:00 PM
Tuesday

By Appointment

Wednesday
11:00 AM - 2:00 PM
  5:00 PM - 7:00 PM
Thursday

By Appointment

Friday
11:00 AM - 2:00 PM
  5:00 PM - 7:00 PM
Saturday

 9:30 AM - 12:30 PM

Sunday
Closed