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Nichols Chiropractic offers our patient form(s) online so they can be completed 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.

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

CHIROPRACTIC - NEW PATIENT HEALTH HISTORY FORM

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FUNCTIONAL MEDICINE - NEW PATIENT HEALTH HISTORY FORM

Download & Print Form




Download the Free Adobe Reader®

Contact us to find out more information or to schedule an appointment.

Sign-up using the form or call us at 785-376-0117

Office Hours

Monday:

8:00 am-5:00 PM

Tuesday:

8:00 am-6:00 pm

Wednesday:

8:00 am-5:00 PM

Thursday:

8:00 am-5:00 PM

Friday:

8:00 am-2:00 PM

Saturday:

Closed

Sunday:

Closed

Our Locations

Testimonials

Reviews From our Satisfied Patients

  • "Without the headaches and back aches dragging me down, I've been able to get more accomplished and to feel better at the end of the day than I have in literally years. That is miracle number three. I have found a precious jewel in Nichols Chiropractic. I tell all my friends about them, and I intend to be a loyal patient for a very long time. I thank the Lord for sending me in this direction."
    T.S Manhattan, KS
  • "I went through three months of adjustments and traction that began in January of 2006. I am now pain free 95% of the time, and have Chiropractic treatments nearly once a month to ensure I stay that way. My admiration, gratitude and thankfulness to Dr. Nichols and his staff will be never ending."
    G.W Manhattan, KS
  • "I experienced a 95% improvement in my low back pain after the first adjustment. I would recommend Nichols Chiropractic to anyone looking for low back pain relief."
    M.O. Manhattan- Manhattan, KS

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