Registration Form



  • For Credit Card/PayPal, Use the Form Below.

  • Click on the “PDF Button” further below for Cash, Check, or Money Order.

  • After this form, you will find the Venmo and Zelle Form.


For Credit Card/PayPal, use this Form


For Venmo and Zelle, use this Form


For All Other Payments (Cash, Check, Money Order, Download this PDF Form

PDF Form

Contact Info

29 King Street Chappaqua NY 10514


*DISCLAIMER: Dr. Michael Wald is a doctor of chiropractic with a masters degree in nutrition. He is also a Certified Dietitian Nutritionist and a Certified Nutritional Specialist and Sports Nutritionist. Dr. Wald is certified to provide acupuncture in several states, but not New York. Dr. Wald has two board certifications in nutrition. Dr. Michael Wald earned his MD diploma, but did not complete a residency and is thus not licensed to practice medicine. The information on this site is intended for educational purposes only and is not to substitute for sound medical or health advice. Information contained within this website may change at any time without prior notice. The information on this website is under copyright, 2021.