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Online Forms

Loertscher Chiropractic Clinic offers our patient form(s) online so you can complete it 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) or bring it with you to your appointment.


New Patient Health History Form - Required

This let's us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form

Auto and Work Accident - Optional

Download & Print Form

Pain Chart - Optional

Download & Print Form

Notice: Patient Privacy - Optional

Download & Print Form

Terms of Acceptance - Optional

Download & Print Form 



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Office Hours

Our Regular Schedule

Loertscher Chiropractic Clinic

Monday:

12:00pm

5:00pm

Tuesday:

12:00pm

5:00pm

Wednesday:

Closed

Closed

Thursday:

12:00pm

5:00pm

Friday:

12:00pm

5:00pm

Saturday:

Closed

Closed

Sunday:

Closed

Closed

Location

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