Lake Marion Chiropractic offers our patient form(s) online so they can be completed it 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.

Chiropractic Case History/Patient Information and Consultation Questionnaire Form # 1

Download & Print Patient History Form

Chiropractic Patient Update Form # 2

Download & Print Form

Lower Extremity Functional Scale Form # 3

Download & Print Form

DASH Reference Form # 4

Download & Print Form

General Pain_Index Questionnaire Form #5 GPI

Minnesota High School Sports Physical Forms #6

Patient Summary Form #7

Download & Print Form

Neck Index #8

Download & Print Form

Back Index #9

Download & Print Form

Member Wellness Registration Form

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!