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If you prefer to complete your new patient forms prior to arriving for your appointment, A L Wagner Family Chiropractic offers our patient forms online so they can be easily printed and 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 appropriate form(s), print it out and fill in the required information.
  • Bring the completed forms with you to your appointment.

New Patient Forms:

Pediatric New Patient Form (Newborn - 12 Years Old):  Download & Print Form

Adolescent New Patient Form (13 - 17 Years Old):  Download & Print Form

Adult New Patient Form (18 - 64 Years Old):  Download & Print Form

Medicare New Patient Form (65 + Years Old):  Download & Print Form

Sign up using the form or call us at 701-557-7455.

THIS ---->https://alwfamilychirocom.chiromatrixbase.com/online-forms.html

Office Hours

Day Open Closed
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9am 9am* 9am 9am* 9am Closed Closed
5pm 5pm* 5pm 2:30pm* 3pm

*Washburn Clinic Hours

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