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Online Forms

The Chiropractic Centers offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • Download the necessary form(s), print it out and fill in the required information.

  • Fax us (785-540-4041) your printed and completed form(s) or bring it with you to your appointment.

  • Bring with you your driver's license of id.

  • Bring with you your insurance card.

  • Bring a list of any prescription medications and supplements you may be taking.

  • Bring any questions, concerns, and goals regarding your wellness you may have.

These items helps us to know the history and current state of your health. Thank you for helping us provide your care.

 

Download & Print Form

© 2015 by The Chiropractic Service

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