(712) 256-2561     300 W. Broadway, Suite 712, Council Bluffs IA 51503
located in the Omni Centre, above the movie theatre in downtown Council Bluffs

Chiropractic

Massage

Yoga
Tai Chi
Pilates

Forms

Hours

On-line Scheduling

Gift Certificates

Newsletters

Find Us

Meet Us

Please print out the forms needed below or arrive 15 minutes early to complete our forms.

New Patient Forms
     (3 pages, same form used for chiropractic, massage, and yoga.)

Class Registration Form
     (To register for wellness class series or event)

Pediatric History Form
     (Ages newborn - 12 years old)

E-mail:  info@prairielandschiropractic.com          www.prairielandschiropractic.com