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Online Forms

Chiropractic Place Family Wellness Centers offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Intake Form

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!

Download & Print Form


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Locations

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Office Hours

Our Regular Schedule

Onalaska - (608) 783-7735

Monday, Wednesday:

7:00 am - 6:00 pm

Tuesday:

2:00 pm - 6:00 pm

Thursday, Saturday, Sunday:

Closed

Friday:

7:00 am - 12:00 pm

Sparta - (608) 269-4511

Monday, Wednesday:

7:00 am - 6:00 pm

Tuesday:

2:00 pm - 6:00 pm

Thursday:

7:00 am - 11:00 am

Friday:

7:00 am - 12:00 pm

Saturday, Sunday:

Closed

Holmen - (608) 526-4628

Monday, Wednesday:

7:00 am - 6:00 pm

Tuesday, Friday:

7:00 am - 11:00 am

Thursday:

2:00 pm - 6:00 pm

Saturday, Sunday:

Closed