Patient Forms

Winegardner Chiropractic offers our patient form(s) online so they can be completed it 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.

Confidential Patient Information

Download & Print Form


Case History

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New Patient Health History Form - Required

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


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



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Contact Us

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Hours of Operation

Check out our schedule

Office Hours

Monday:

9:00 am-12:30 pm

3:00 pm-6:00 pm

Tuesday:

2:00 pm-5:00 pm

At Body Zone Total Fitness 6-8pm

Wednesday:

9:00 am-12:30 pm

3:00 pm-6:00 pm

Thursday:

10:00 am-2:00 pm

Friday:

10:00 am-12:00 pm

1:00 pm-4:00 pm

Saturday:

Closed

Sunday:

Closed

Our Location

39 N. Plaza Blvd. | Chillicothe, Ohio, 45601

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