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Request an Appointment

Kleefeld Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

Please click on link below and follow the instructions to complete the requested information:

https://pdf.ac/20SYHu


Authorization Form

Download & Print Form


Consent Form

Download & Print Form


Office Policies

Download & Print Form


Massage Therapy

Download & Print Form


Pain Diagram

https://pdf.ac/ap8Quv


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 chiropractic office. You can print the form out and bring it in to our office during your next visit with our chiropractor, 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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