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17202 Midland Drive

Shawnee, KS 66217 US

913-268-8300

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Online Forms

Swickard Chiropractic Clinic of Shawnee, P.A. offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • 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.
  • If you do not already have AdobeReaderĀ® installed on your computer, Click Here to download.

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! 

Please print, fill out, and complete the entire form prior to your visit. Be specific with your symptoms, and please list them separately (i.e. headache and neck pain are two separate symptoms).

If you are a NEW PATIENT, Click Here to download and complete the form.

If you are a new or existing patient who has suffered an injury due to a recent AUTO ACCIDENT, Click Here to download and complete the form.

If your CHILD (AGE 12 OR UNDER) is a new patient, Click Here to download and complete the form.




Please click the button below to request an appointment.





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Testimonials

Reviews By Our Satisfied Patients

  • "I went for my first time and loved it. The staff there was so kind and helpful, not to mention my back feels so much better!"
    Rhiannon F.

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