New Patient Intake Form

This form provides us with information about you, the type of discomfort you are in, and how we can help you get on the right track to a healthier lifestyle. Please complete both pages to the best of your ability.

Informed Consent and Payment Policy

These are required and kept confidentially in your records. Informed consent explains the benefits and risks of chiropractic care and gives Dr. Wilhelm permission to treat you prior to beginning care. We accept all forms of payments and many types of  insurance. We require that a payment policy be signed and kept in your records.