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Online Forms

Bluffs Family Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Forms - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

New Patient Intake Form

Pediatric New Patient Intake Form

Patient Health Information Consent Form (HIPAA) 






Download the Free AdobeReader®

We have both morning and afternoon hours and can often see you the same day!

Give us a call and we'll make sure that your time in our office is as convenient for you as possible!

Monday:

8:00 am - 11:30 am

2:00 pm - 5:30 pm

Tuesday:

Closed

2:00 pm - 5:30 pm

Wednesday:

8:00 am - 11:30 pm

2:00 pm - 6:00 pm

Thursday:

8:00 am - 11:30 am

2:00 pm - 5:30 pm

Friday:

8:00 am - 11:30 am

Closed

Saturday:

By Appt.

Closed

Sunday:

Closed

Closed

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