Santa Clara Chiropractic Center
To your health
Your profile is going to be kept confidential and will not be shared with any third party. Please refer to our Privacy Policy for more details.

A valid email address is required in order to activate your account, and also to receive reminders when you setup your appointments on line.

Create Your Account 

Create Your Account

Use this form to create your account. After you submit this form, you'll receive an email which will include instrucions to activate your account. Account activation is required before you can login to the system.


First Name: *
Last Name: *
User Name: *  
Password: *  
Confirm Password: *  
Phone Number: *  
Email: *  
Confirm Email: *  
Security Question: *
Security Answer: *
New patient:
Yes No
How were you referred to us:    *
I would like to receive emails about promotions that Santa Clara Chiropractic Center will run occasionally.
Copyright © 2007-2017 Santa Clara Chiropractic Center. All rights reserved.
Powered by XteraNet