Prairielands Chiropractic Clinic offers forms online so they can be completed at your convenience, submitting online or printing and bringing with you.
- Complete and submit online or download the necessary forms. If you do not already have AdobeReader® installed on your computer, Click Here to download.
Please complete our 2 forms for new patients:
New Patient Online Form or Print Form
Health Intake Online Form or Print Form
New Pediatric (birth-12 years old) Patient Online Form or Print Form
Do you have a claim number and need to be a new personal injury patient? New Personal Injury / Work Comp Online Form or Print Form
Massage Consent Online Form or Print Form
If pregnant, do this also: Pregnancy Massage Informed Consent Form or Print Form
Print Member Wellness Registration Form - Optional