Request an Appointment

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. Remember, you do not have a scheduled appointment until we can call you and verify this appointment request.

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Appointment Request Form

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First Name: *

Last Name: *

Telephone Number: *

E-mail address: *

Date for Requested Appointment *

Time for Requested Appointment *

I am a current patient.

I am looking to make an appointment to become a new patient

Message to Our Office Staff (optional): *

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Need an Appointment?

Give us a call at: 770-459-8439

Or use our online appointment form

Contact Details

Villa Rica Chiropractic

Wellness Center

117 S Carroll RD

Villa Rica, GA 30180

info@VillaRicaDC.com

Practice Hours

Monday, Wednesday, Friday

9 - 12 2 - 6

Tuesday

12 - 4

By Appointment Only

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