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.
  • Download the necessary form(s), print it out and fill in the required information.
  • 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!

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Counselman & Wade Chiropractic

Address

1408 SW Topeka Blvd,
Topeka, KS 66612

Office Hours

Monday  

9:00 am - 1:00 pm

3:00 pm - 6:00 pm

Tuesday  

9:00 am - 1:00 pm

3:00 pm - 6:00 pm

Wednesday  

9:00 am - 1:00 pm

3:00 pm - 6:00 pm

Thursday  

9:00 am - 1:00 pm

3:00 pm - 6:00 pm

Friday  

Closed

Saturday  

Closed

Sunday  

Closed

Contact Us Today

We look forward to hearing from you