New Patient Paperwork

Main Street Chiropractic and Rehab offers our patient form(s) online so they can be completed 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 them with you to your appointment.

Cost of Care

Providing affordable care is very important to us. We do participate with most insurance companies. To find out if chiropractic is a covered service under your insurance plan, please contact your insurance provider.

Exam - $30-$70

Adjustment - $30-$50

Therapy - $25

Laser Therapy - $35 or 4 for $100

*Discounted services for uninsured patients are income based and must meet federal guidelines. If you have any questions or concerns regarding our fees, please give us a call at (734) 699-6600. Forms of payment accepted include: cash, check, or credit card. Payment is expected the same day services are performed.


8:00am - 1:00pm
3:00pm - 7:00pm

8:00am - 1:00pm
3:00pm - 7:00pm

8:00am - 1:00pm
3:00pm - 7:00pm

8:00am - 1:00pm
3:00pm - 7:00pm

8:00am - 1:00pm

By Appointment

Main Street Chiropractic and Rehab
243 Main Street
Belleville, MI 48111
(734) 699-6600