Online Forms

Clem Chiropractic Center 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

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!

Current Patient Reexamination

It's time for your reexamination!  In order for us to best monitor your progress as well as make the best Chiropractic Healthcare recommendations, we ask that you please avoid the use of the following four to eight hours prior to your Reexamination: Nicotine,Coffee, Ice, Hot Packs, and NASIDS ( Non Steriodal Anti-Inflammatory Drugs ) unless you are currently on a specific drug therapy from your medical doctor.

Specials

Member Wellness

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!