Online Forms

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!

Download & Print Form


Download the Free AdobeReader®

Office Hours

Our Regular Schedule

Dr. Dennis Wade

Monday

8:00 am - 12:00 pm

2:00 pm - 5:30 pm

Tuesday

8:00 am - 12:00 pm

2:00 pm - 5:30 pm

Wednesday

8:00 am - 12:00 pm

2:00 pm - 5:30 pm

Thursday

8:00 am - 12:00 pm

Friday

Closed

Saturday

Closed

Sunday

Closed

Dr. Brett Counselman

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

Dr. Demetra "Dee" Moore

Monday

9:00 am - 1:00 pm

2:00 pm - 6:00 pm

Tuesday

9:00 am - 1:00 pm

2:00 pm - 6:00 pm

Wednesday

9:00 am - 1:00 pm

2:00 pm - 6:00 pm

Thursday

9:00 am - 1:00 pm

Friday

Closed

Saturday

Closed

Sunday

Closed

Dr. Dennis Wade

Monday
8:00 am - 12:00 pm 2:00 pm - 5:30 pm
Tuesday
8:00 am - 12:00 pm 2:00 pm - 5:30 pm
Wednesday
8:00 am - 12:00 pm 2:00 pm - 5:30 pm
Thursday
8:00 am - 12:00 pm
Friday
Closed
Saturday
Closed
Sunday
Closed

Dr. Brett Counselman

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

Dr. Demetra "Dee" Moore

Monday
9:00 am - 1:00 pm 2:00 pm - 6:00 pm
Tuesday
9:00 am - 1:00 pm 2:00 pm - 6:00 pm
Wednesday
9:00 am - 1:00 pm 2:00 pm - 6:00 pm
Thursday
9:00 am - 1:00 pm
Friday
Closed
Saturday
Closed
Sunday
Closed

Our Locations

Choose either of our Southern California locations

Contact Us Today

We look forward to hearing from you