Online Forms

Langel Chiropractic Clinic, P.C. offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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.

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


Consent to Treat a Minor Form

Download & Print Form


Current Patient Update

Download & Print Form


United Health Care Insurance Forms

UHC Arm Shoulder and Hand Index

UHC Back Index

UHC Lower Extremity Index

UHC Neck Index

UHC Patient Summary Form

UHC Start Back Musculoskeletal Screening Tool



Download the Free AdobeReader®

CONTACT US TODAY

We look forward to hearing from you

Location & Hours

Location

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Office Hours

Our Regular Schedule

Monday:

7:30 am-12:30 pm

2:00 pm-6:00 pm

Tuesday:

7:30 am-12:30 pm

2:00 pm-5:00 pm

Wednesday:

1:00 pm-6:00 pm

Thursday:

7:30 am-12:30 pm

2:00 pm-5:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed