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Welcome to Gerstenkorn Family Chiropractic

New Patient Forms

Please download and print your New Patient Forms by clicking on the links below:

Confidential Patient Health Forms (2 pages)

Back Pain Index

Neck Disability Index

Consent Form

Welcome Form

HIPAA Agreement Form (2 pages)

Medicare Financial Forms

2014 Medicare ABN Form

If you have any questions, please call us!  Gerstenkorn Family Chiropractic : (219) 374-8190

Chiropractic Website by Perfect Patients.