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Online Forms

Prairielands Chiropractic Clinic offers forms online so they can be completed at your convenience, submitting online or printing and bringing with you.

  • Complete and submit online or download the necessary forms. If you do not already have AdobeReaderĀ® installed on your computer, Click Here to download.

Please complete our 2 forms for new patients:

New Patient Online Form or Print Form
Health Intake Online Form or Print Form

New Pediatric (birth-12 years old) Patient Online Form or Print Form

Do you have a claim number and need to be a new personal injury patient? New Personal Injury / Work Comp Online Form or Print Form

Massage Consent Online Form or Print Form
If pregnant, do this also:  Pregnancy Massage Informed Consent Form or Print Form

Print Yoga Waiver Form