Office Forms

Because your time is valuable, feel free to download our office forms and fill them out before your first visit. If you have any questions you can contact the office at (785) 856-6430.

For New Patients

Please complete both forms for your first visit

Patient Personal/Confidential Data Form

HIPAA Release Form

For Worker's Compensation

Please complete the following forms

Worker's Comp Injury Questionnaire

Worker's Comp: Authorization for Treatment

(Note: It is necessary that your employer sign the following authorization and return it to our office.)

Adjustments Toward a Healthy Lifestyle