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Online Forms

ONLINE FORMS IN TOPEKA, KS

Counselman & Wade Chiropractic offers our patient form(s) online so you can complete 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.
  • Click Here
  • Fax us (785-234-2405) your printed and completed form(s) or bring it 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