Accessibility View Close toolbar

Contact Us

Online Forms

Chiropractic Care Center ~ Franklin 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 Adobe Reader® 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) (414-525-9927) or bring it with you to your appointment.

New Patient (Adult) Health History ~ Required

This paperwork lets us know the history and current state of your health.

Click here to Download & Print Form

New Patient (Child ~ 0-9 years old) Health History

This paperwork lets us know the history and current state of your child's (ages 0-9 years) health. If some sections of the paperwork do not apply, please feel free to leave them blank.

Click here to Download & Print Form

New Patient (Work or Car Injury Related) Health History

This paperwork is for new patients that have been in a work or car accident.

Click here to Download & Print form

HIPAA Privacy Policy

This paperwork is for you to view and read if you would like. You do not need to print it or bring it to the office.

Click here to Download Privacy Policy

Established Patient Re-Exam Paperwork

This paperwork is for established patients who have an upcoming appointment for a re-examination. Please print it and fill it out to the best of your ability.

Click here to Download & Print form