Paperwork Convenience
Online Forms
Here at Midwest Chiropractic and Wellness we want to ensure that you receive the best care available with the smoothest patient experience possible. Use our online forms as they may apply to you and save yourself some time!
New Patient Intake Form
If this is your first visit to our clinic please click this box to fill out your Medical History and General Information. This will save you time in your first visit to see Dr. Mitch or Dr. Zach
Auto/Personal Injury Forms
If you were injured in an Auto accident or visiting us with a Workers Comp claim. Click this box to fill out the paperwork prior to your first visit. Be sure to bring either your Auto or Works Comp claim numbers if filling out in the clinic.
Contact Us
If you have any questions about your insurance, claim process, or payment methods/options reach out anytime! We are here to make your treatment experience as smooth as possible.
