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www.nokomischiropractic.com

Online Forms

Nokomis Chiropractic & Wellness offers our new patient form(s) online so it can be completed in the convenience of your home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary forms, print them out and fill in the required information.
  • Bring them with you to your appointment.


New Patient Health 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!

Please Download and Print Forms.  By bringing them in filled out you will save some time on your initial visit.


Member Wellness Registration Form - Optional

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!

Download & Print Form


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