Online Forms

Wunderlich Chiropractic Clinic 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 Intake Forms

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 and fill out these forms prior to your visit.

hippa-disclosure.pdf

patient-demographic-information.pdf

patient-history-form.pdf

patient-intake-1.pdf

privacy-practices.pdf

terms-of-acceptance.pdf


Neck and Back Pain Disability Assessment - Required

Select the one that applies to your current problem

oswestry-neck.pdf

oswestry-back.pdf


Minor Consent Form

Complete if patient is under 18

minor-consent.pdf


Medicare Explanation 

medicare-explanation.pdf


Location

Find us on the map

Office Hours

Office Hours May Differ Due to COVID-19

Monday:

8:00 am - 2:00 PM

Tuesday:

8:00 am - 12:30 pm

1:00 pm-4:00 pm

Wednesday:

8:00 am - 2:00 pm

Thursday:

8:00 am - 2:00 pm

Friday:

8:00 am - 12:00 pm

Saturday:

Closed

Closed

Sunday:

Closed

Closed

Testimonials

Reviews By Our Satisfied Patients

  • "Dr. Wunderlich finds the problem and takes care of it. He doesn't drag out the visits. He treats the issue, explains what is going on and tells you what to do to prevent it from happening again. I can count on knowing my issue will be taken care of and I recommend Dr. Wunderlich.to anyone who has pain."
    Joanie Smith - Cape Coral, FL