New Patient Paperwork

Harnish Family Chiropractic offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them...
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.
Monday8:00am - 11:30am
2:00pm - 5:30pm
Wednesday8:00am - 11:30am
2:00pm - 5:30pm
Friday8:00am - 11:30am
2:00pm - 5:30pm
Chiropractic Bellville OH Harnish Family Chirorpactic Logo

Harnish Family Chiropractic
110 Main Street
Bellville, OH 44813
(419) 886-4444

Recommended Chiropractor


“Dr. Harnish has been my chiropractor for 22 years! He has continued to treat my entire back since and I feel great!”

- Dorothy

“I suffered from severe neck and back pain and was treated at least 2 times a week or more for 6 months with a little temporary relief. After 2 months I was 75% consistently better and now after 4 months I am 90% consistently better.”

- Ron

“Dr. Harnish adjusted my foot and also worked on my back and in 6 weeks my foot pain was 90% better and so was my back and hip.”

- Richard

Recommended Chiropractor - White

110 Main Street
Bellville, OH 44813