Online Forms

For your convenience, Sioux Center Chiropractic offers our patient forms online so you can complete them in the comfort of your own home or work.  Please fill out this form completely prior to your appointment. Completing this form ahead of time saves you valuable time in the office and allows our doctors to review it prior to your appointment which will make for a more efficient examination. If you cannot complete your paperwork prior to your first visit, please come to the office 15 minutes early to complete it in our office. Don’t hesitate to call if you have any questions.

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!

*It is recommended to fill this out on your computer, NOT on your mobile device (phone/tablets).

Online Patient Intake Form

Sports Physicals

Please complete the health history and personal information as thoroughly as possible prior to coming in for your sports physical.

Iowa Athletic Pre-Participation Form


DOT Forms

Please COMPLETELY fill out pages 1-2 of the Medical Examination Report Form (See page 6 for guidance).

DOT Checklist
DOT Form



Please review the Informed Consent and office policies prior to your appointment. Submission of the online paperwork includes these forms for acknowledgement. They are available to download for your records:

Informed Consent
Financial Policy
HIPPA Privacy Policy