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Online Forms

Associated Chiropractic &Wellness Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) to 319-366-8615 or bring it 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!

New Patient Health History Forms Download & Print Form

New Auto Accident Forms  Download & Print Form


New Patients Receive a Free Consultation.

Sign-up using the form or call us at 319-366-4118 to take advantage of this exclusive offer.

Office Hours

Monday:

8:00 am-6:00 pm

Tuesday:

8:00 am-1:00 pm

Wednesday:

8:00 am-6:00 pm

Thursday:

1:00 pm-6:00 pm

Friday:

8:00 am-1:00 pm

Saturday:

Closed

Sunday:

Closed

Location

Click the map to view the location nearest to you