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Online Forms

Geers Family Chiropractic 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.


If you are considering becoming a new patient and would like to fill out the paperwork ahead of time, choose from the following:

New Patients 13 or older: Chiropractic Health Questionnaire

New Patients 12 or younger: Child Chiropractic Health Questionnaire

New Massage Clients: Massage New Patient

For our existing patients, we would love to hear your success story! Please print and fill out the following testimonial and mail it or drop it off to us. We have started a binder for patient testimonials. We would love to share how chiropractic helped you with others!

Download the Free AdobeReader®

Geers Family Chiropractic

Office Hours


9:00 AM-12:30 pm

2:00 pm-6:00 pm


9:00 AM-12:30 pm

2:00 PM-6:00 pm


9:00 AM-12:30 pm

2:00 pm-6:00 pm


9:00 AM-12:30 pm

2:00 pm-6:00 pm


9:00 am-12:30 pm

2:00 pm-5:00 pm


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