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New Patient Forms

Wellcare Chiropractic Center offers our patient forms so they can be completed in the convenience of your own home or office, before you arrive to your appointment.

  • Download the necessary form(s)by clicking the link, print and fill in the required information.
  • Bring these forms with you to your appointment.
  • Forms are specific for Chiropractic, Acupuncture, Massage and Ideal Protein
  • If you do not already have AdobeReaderĀ® installed, Click Here to download.

Chiropractic: (please fill out 1-3)

1) Online Registration (this form is completed online) 


2) Financial Policies and HIPPAA Privacy Notice Receipt (as it applies to your current situation). Download and bring this form with you to your appointment.  Click here to read the HIPPAA Privacy Notice


3) Complete these Questionnaire forms as they apply to your area of pain. Please download and bring with you to your appointment.

     -  Neck Pain   -  Upper Extremities (arms/hand)
     -  Low Back Pain (online form)   -  Lower Extremities (legs/knees/feet)
     -  Headaches


Massage:  Massage Registration Form

Ideal Protein:  Health Profile Form

Office Hours

Monday  

9:00 am - 1:00 pm

3:00 pm - 7:00 pm

Tuesday  

8:00 am - 12:00 pm

1:00 pm - 5:00 pm

Wednesday  

9:00 am - 1:00 pm

3:00 pm - 7:00 pm

Thursday  

8:00 am - 12:00 pm

1:00 pm - 5:00 pm

Friday  

8:00 am - 12:00 pm (Appointment Only)

Saturday  

Closed

Sunday  

Closed