Call Today:  (260) 338-1700
 

New Patient Paperwork

 

The Chiropractic Rehab & Wellness Center offers patient forms you can download from the convenience of your home or office.

All forms are PDF files. If you do not already have AdobeReader® installed on your computer, you can download it free by Clicking Here.

Just download the necessary form(s) below, print them out and fill in the required information. Fax us your printed and completed form(s) or bring it with you to your appointment.

Office Hours
Monday8:30am - 5:30pm
Tuesday10:00am - 5:30pm
Wednesday8:30am - 5:30pm
Thursday10:00am - 5:30pm
Friday8:30am - 4:30pm
Sat-SunClosed
Highly Recommended Chiropractor
What Our Patients Are Saying

"Dr. Miller is knowledgeable and thorough. He is personable and does a great job at addressing spinal issues and more."
- Gene

"What they do truly makes a difference in peoples lives everyday and has had made all the difference in my life!"
- Stephanie

"They take care of the problem and help you understand possible causes. They will also do rehab to help the issue as well, not just the adjusting."
- Jennifer

Office Hours
Monday8:30am - 5:30pm
Tuesday10:00am - 5:30pm
Wednesday8:30am - 5:30pm
Thursday10:00am - 5:30pm
Friday8:30am - 4:30pm
Sat-SunClosed
Chiropractic Rehab & Wellness Center
The Chiropractic Rehab & Wellness Center
10528 Coldwater Rd
Fort Wayne, IN 46845
(260) 338-1700
Chiropractor
Share With Your Friends:
Recommended chiropractor