New Patient Paperwork

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

*IMPORTANT NOTE FOR APPLE DEVICE USERS: If filling forms out on an Apple device, please refrain from using Safari. Please use Google Chrome.

Online Forms

  • New Patient Paperwork | ONLINE

    Click to Complete Online

  • Existing Patient Paperwork | ONLINE

    Click to Complete Online

Printable Forms

  • New Patient Paperwork | PRINTABLE

    Click to Print Paper Version

  • Existing Patient Paperwork | PRINTABLE

    Click to Print Paper Version

OFFICE HOURS

Monday
9:00am - 6:00pm

Tuesday
2:00pm - 5:00pm

Wednesday
9:00am - 6:00pm

Thursday
9:00am - 6:00pm

Friday
Closed

Saturday & Sunday
Closed

Back to Health Chiropractic

2504 Monroe St
La Porte, IN 46350

P: (219) 326-5100
F: (219) 326-0180