Accessibility View Close toolbar

Online Forms

City Center Chiropractic offers our patient forms online so they can be completed right where you are, anywhere and any time.

  • If you don't already have AdobeReaderĀ® installed on your computer, Click Here to download.
  • Coming to see us for the first time?  We need the New Patient Packet.  You can either fill it out when you get here, or download the online version below, under "New Patient Packet".
  • Have you been in a car crash?  If we'll be billing your auto insurance, we need the forms located under "Personal Injury Forms", as well as those in the New Patient Packet.
  • Worker's Compensation: You can and should print out and fill in the New Patient Packet, but you should expect additional paperwork upon arrival at the clinic.  We're hard at work on a digital solution, but for now, we apologize but this is how it has to go.
  • Bring your photo identification and your insurance card(s) with you to your appointment for the smoothest experience.

New Patient Packet

This gives us some basic information about you, including your contact information and medical history. It also contains a basic sketch of our financial policy, and your signature is required in order to be seen as a patient.  Also included are function questionnaires that help us track your progress.

Download & Print Form

Personal Injury Forms

If you have been involved in an auto accident, we ask that you also bring in the following forms.

Auto Accident Questionnaire

Power of Attorney (for checks)

Contact Us Now

Why not get started today? (907) 463-5255

Location

Find us on the map

Office Hours

Our Regular Schedule

800 Glacier Avenue

Monday:

8:00 am-1:00 pm

3:00 pm-5:30 pm

Tuesday:

3:00 pm-5:30 pm

Wednesday:

8:00 am-1:00 pm

3:00 pm-5:30 pm

Thursday:

8:00 am-1:00 pm

Friday:

8:00 am-1:00 pm

3:00 pm-5:30 pm

Saturday:

Closed

Sunday:

Closed