Online Forms

Prairie Family & Sports Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or 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 Case History Form - 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!

Download & Print Form

Terms of Acceptance Consent Form - Required

Download & Print Form

Notice of Privacy - Required

Download & Print Form

Consent For Use & Disclosure

Download & Print Form


Case History Update Form (For Existing Patients ONLY)

Download & Print Form

Workers Compensation Accident Report

Download & Print Form

Auto Accident Report

Download & Print Form


Download the Free AdobeReader®

CONTACT US TODAY

We look forward to hearing from you

Office Hours

Our Regular Schedule

Monday

8:00 a.m.

6:00 p.m.

Tuesday

9:00 a.m.

5:00 p.m.

Wednesday

8:00 a.m.

6:00 p.m.

Thursday

By Appt.

By Appt.

Friday

8:00 a.m.

6:00 p.m.

Saturday

Closed

Closed

Sunday

Closed

Closed

Monday
8:00 a.m. 6:00 p.m.
Tuesday
9:00 a.m. 5:00 p.m.
Wednesday
8:00 a.m. 6:00 p.m.
Thursday
By Appt. By Appt.
Friday
8:00 a.m. 6:00 p.m.
Saturday
Closed Closed
Sunday
Closed Closed

Locations

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