Online Paperwork

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use and why we need them.


Health History and Future

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?
  Download & Print Form


Quadruple Visual Analogue Scale

This form helps us understand what kind of pain you are is so we can help you feel better faster.
  Download & Print Form


HIPPA Privacy Form

This notice describes how chiropractic and medical information about you may be used ans disclosed and how you can get access to this information.
  Download & Print Form


Free AdobeReader®

Each form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

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Dr. John  Asks some important questions of interest to Madison residents - Chiropractor Madison Dr. John Asks...

Can someone who has had back surgery receive chiropractic care?
Yes. Rest assured that we will avoid the surgically modified areas of your spine. However, what we find is that surgical interventions will often produce spinal instability above or below the involved level. This is will be the focus of your chiropractic care.
How do you "catch" a cold?
Simply lower your resistance by avoiding the proper rest and exercise, eating lots of sugar and junk food, putting up with emotional stress and neglecting your nervous system by avoiding your chiropractor. You won't have to catch a cold because it will catch you!