In his 1856 journal, the great American philosopher and naturalist Henry David Thoreau wrote, "I love the winter, with its imprisonment and its cold, for it compels the prisoner to try new fields ...View Article
You are using an outdated browser. Please upgrade your browser to improve your experience.
Draeger Chiropractic & Laser Center offers our patient forms online so that you can save time at your visit by completing them before you even arrive at our chiropractic office.
This outlines the history and current state of your health. We also encourage you to write down any questions that you have, so that we can be sure to cover them during your appointment. Choose the appropriate form based on the patient's age.
If you are a returning patient, but haven't been to our office within the past 3 months, we will need to collect more recent health information. Please choose the appropriate form based on how long it's been since your last visit (if you're unsure, please don't hesitate to call us at 715-355-4224).
This worksheet helps you to understand your insurance coverage by outlining the questions you should ask your insurance provider. It is important to know that it is your responsibility to verify your coverage and understand your financial share of the services we provide. We strongly recommend that you bring this completed form with you to your first appointment. Download & Print Form.
To transfer medical records between our office and another provider. Download & Print Form
If your visit to our office was because of an injury that happened at work, please use this form. It is required for all Workers' Compensation claims. Download & Print Form
Our staff will let you know if this form is required as a supplement to Form #1 (Patient Health History).
If you are a Nutrition or Functional Medicine patient, the doctor may ask you to complete one or more of these forms:
We invite you to access the member wellness section of our website and to subscribe to our monthly e-newsletter. You can register online or download & print the form and bring it with you to your next visit.