Schedule today to get started on your path to wellness! Appointment Request FormUse the form below to request an appointment. Select a first and second appointment preference date and time. Our office will contact you to confirm scheduling based on appointment availability. First Name * Last Name * Phone * Email * First Choice Date * First Choice Time * Second Choice Date * Second Choice Time * Preferred Office * ---BoardmanHubbardKinsmanNo PreferenceAdditional CommentsPlease do not send personal medical or health information via this form. Our office can discuss these matters with you in detail during our telephone conversation with you.Yes! Please add me to the Advanced Chiropractic & Rehab, Inc. newsletter list so that I may receive special offers and more.