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Regional Chiropractic Center 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


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our chiropractic office. You can print the form out and bring it in to our office during your next visit with our chiropractor, or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



Download the Free AdobeReader®

Sign up using the form or call 765-452-0888 to make your appointment.

THIS ---->https://regionalchiropracticcenter.com/online-forms.html

Office Hours

DayMorningAfternoon
Monday9:00am5:30pm
Tuesday9:00am1:00pm
Wednesday9:00am6:30pm
ThursdayClosedClosed
Friday9:00am5:30pm
SaturdayClosedClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9:00am 9:00am 9:00am Closed 9:00am Closed Closed
5:30pm 1:00pm 6:30pm Closed 5:30pm Closed Closed

Testimonial

I LOVE Regional Chiropractic Center! The people here are so wonderful and welcoming EVERY time I go in. Everyone here has truly gone above and beyond to help me. I am pretty sure it is one of my baby girl's favorite places to go with me considering how they spoil her :) Dr. Ladd is the best, as well as the rest of the staff. Highly recommend!

Halee B.
Kokomo, IN

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