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Practice Name

Bolz Chiropractic

Social Media
Primary Location
4990 SW 21st Street
Topeka, KS 66604
Phone: 785-272-2090

Office Hours

DayOpenClosed
Monday7:30 am5:30 pm
Tuesday7:30 am5:30 pm
Wednesday7:30 am5:30 pm
Thursday8:00 am2:30 pm
Friday7:30 am5:30 pm
SaturdayEmergencies OnlyClosed
SundayClosedClosed
Main Content

Bolz Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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 lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Application for Treatment

Additional Forms

Additional Forms for Newborns to Age 5



Download the Free AdobeReader®

Exclusive Offer

Do you know about our association with ChiroHealthUSA?

ChiroHealth is a good alternative or supplement to your traditional medical insurance that can earn you special discounts at Bolz Chiropractic. It's only $49 for the year! Read more about ChiroHealthUSA here.

Request more information using the form or call us at 785-272-2090

Name: *
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Online Forms

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


Application for Treatment

Additional Forms

Additional Forms for Newborns to Age 5

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Office Hours

We will do our best to accommodate your busy schedule. Request an appointment today!

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Our Services

We strive to provide complete care for our patients. Learn more about all the services we provide.

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Contact

Bolz Chiropractic
4990 SW 21st Street
Topeka, KS 66604
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Office Hours

DayOpenClosed
Monday7:30 am5:30 pm
Tuesday7:30 am5:30 pm
Wednesday7:30 am5:30 pm
Thursday8:00 am2:30 pm
Friday7:30 am5:30 pm
SaturdayEmergencies OnlyClosed
SundayClosedClosed
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