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Online Forms

ONLINE FORMS IN TOPEKA, KS

Counselman & Wade Chiropractic offers our patient forms online so you can complete them conveniently from your home or office. Simply click the link below to access and fill out the form digitally—no additional software required.
Once completed, you may:
  • Fax it to (785-234-2405), or
  • Bring a printed copy with you to your appointment

New Patient Health History Form - Required

This let's us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!
Contact
us
Office hours 
& location
Monday
9:00 am — 6:00 pm
Tuesday
9:00 am - 6:00 pm
Wednesday
9:00 am - 6:00 pm
Thursday
9:00 am - 6:00 pm
Friday
Closed
Saturday & Sunday
Closed
Counselman & Wade Chiropractic
1408 SW Topeka Blvd
Topeka, KS 66612
We don't see patients between 1-3PM