New Patient Paperwork

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

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.
  • New Patient Intake Form

    Click to Complete

  • New Patient Health History Form

    Click to Download

  • Function Rating Index

    Click to Download

  • Consent Form

    Click to Download

  • Authorization Form

    Click to Download

Monday
9:30am - 12:30pm
3:00pm - 6:00pm


Tuesday
9:30am - 12:30pm
3:00pm - 6:00pm


Wednesday
9:30am - 12:30pm
3:00pm - 6:00pm


Thursday
9:30am - 12:30pm
3:00pm - 6:00pm


Friday
Closed


Saturday & Sunday
Closed

Chiropractic Lincoln NE Highly Recommended

Southwest Chiropractic Center PC

1501 Pine Lake Road, #2
Lincoln, NE 68512

(402) 421-8284