New Patient Forms

Welcome to Dynamic Chiropractic! We are excited that you have chosen to take the first step toward a pain-free life. Please contact us to set up your New Patient appointment.

To save you time during the appointment, we have included on this site a few simple forms that we ask you to complete. We encourage you to print and complete these forms before bringing them along on your first visit.

If you have any questions about what to expect, please check out our First Visit page, or simply give us a call at 608-273-2222. We are eager to see you!

Patient Medical History Form

Consent for Use or Disclosure of Health Information Form

Informed Consent Form

Payment Policy (for cash and insurance payments)

Payment Policy (for Worker’s Compensation and Personal Injury payments)