Online Forms

Nichols Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.


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


FUNCTIONAL MEDICINE - NEW PATIENT HEALTH HISTORY FORM


Medical Records Release Form


CHIROPRACTIC-NEW PATIENT HEALTH HISTORY FORM: CHILD CASE


INFORMED CONSENT FOR DRY NEEDLING:


Personal Injury Auto Accident


WORK INJURY POLICY


Medicare Advanced Beneficiary Notice of Non-Coverage (ABN):



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

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

Location

Office Hours

Monday:

8:00 am-1:00 pm

2:00 pm-5:00 pm

Tuesday:

8:00 am-1:00 pm

2:00 pm-6:00 pm

Wednesday:

8:00 am-1:00 pm

2:00 pm-5:00 pm

Thursday:

8:00 am-1:00 pm

2:00 pm-5:00 pm

Friday:

8:00 am-2:00 pm

Saturday:

Closed

Sunday:

Closed