Online Forms

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!

Please print pages individually. Do not print front and back

Application for Treatment

Additional Forms

Additional Forms for Newborns to Age 5



Download the Free AdobeReader®

Office Hours

Our Regular Schedule

Monday

7:30 am

5:30 pm

Tuesday

7:30 am

5:30 pm

Wednesday

7:30 am

5:30 pm

Thursday

7:30 am

5:00 pm

Friday

7:30 am

5:30 pm

Saturday

Emergencies Only

Closed

Sunday

Closed

Closed

Monday
7:30 am 5:30 pm
Tuesday
7:30 am 5:30 pm
Wednesday
7:30 am 5:30 pm
Thursday
7:30 am 5:00 pm
Friday
7:30 am 5:30 pm
Saturday
Emergencies Only Closed
Sunday
Closed Closed