Request an Appointment

C.A.F.E. of Life Chiropractic, Inc.
2059 PA Route 309
Allentown, PA 18104
610-366-1336
info@cafeoflifechiropractic.net
*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
9:00 - 12:00, 3:00 - 6:30
Tuesday
3:00 - 6:30
Wednesday
9:00 - 12:00, 3:00 - 6:30
Thursday
9:00 - 12:00, 3:00 - 6:30
Friday
Closed
Saturday
9:00 - 10:00
Sunday
Closed