Online Forms

Want To Save 20 Minutes. Download your forms NOW!

Not scheduled for your initial appointment yet?

Email Mariellen  or call (641) 228-3142 to reserve your appointment slot today!


New Patient Personal Wellness Review

 Download & Print Form


Adult Health History Form

 Download & Print Form


Child Health History Form

 Download & Print Form


Motor Vehicle Accident History

 Download & Print Form


Free AdobeReader®

Each form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

Subscribe to our Charles City chiropractic newsletter Free Newsletter

Receive free professional health tips on topics that interest you.
 
 
Select Topics:
Backaches & Sciatica
Headaches & Neck Pain
Wellness Topics
Diet & Nutrition
Exercise & Fitness
Women's Health Issues
Children's Health Issues
Stress Management

Dr. Tony Asks some important questions of interest to Charles City residents - Chiropractor Charles City Dr. Tony Asks...

Can babies with colic be helped with chiropractic?
It's probably one of the times a parent feels the most helpless. But based on the research, chiropractic and colic relief appear to go hand in glove. With success rates in the mid-90% range, more and more Charles City parents are seeing a chiropractor. If you have a baby with colic learn how chiropractic may help.
Would you rather feel good or be healthy?
Ask most people in Charles City and they want to feel good. Careful! Would you take medicine that makes you feel good, rather than vomit to expel improperly prepared food? Every chiropractic practice member knows that you can't measure your health by how you feel. True health is when your body works as it should.