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New Chiropractic Patient Forms

We offer our paperwork online so you can complete it in the convenience of your own home. Please be advised, a current version of either Java® or Adobe Reader® is required to be able to submit the forms.


Essential Forms

Please fill out our essential forms and submit online before your visit.


Mind Fit Forms

The following forms are available for you to download, print, and bring with you on your first visit. This will significantly decrease your amount of wait time in the office.

Mind Fit Intake Form

Financial Policy


Shape Reclaimed Forms

The following forms are available for you to download, print, and bring with you on your first visit. This will significantly decrease your amount of wait time in the office.

Shape-ReClaimed-Questionnaire

Shape Reclaimed Agreement for Weekly Consultation

Financial Policy

SHAPE Informed Consent & Acceptance of Responsibility 2016

Shape Reclaimed Intake Form


Free AdobeReader®

Get adobe readerEach 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.

Spinal problems rarely get better on their own. Call our St. Charles chiropractic office today to get started with chiropractic care!


Free Java®

JavaIf you do not have a current Java® installed on your computer, click the Java® image to download for free.

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