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Chiropractic & Wellness - New Patient Forms

Our new patient forms may be filled out online or they can be downloaded, printed, and filled out.  Fax us your printed and completed form(s) or bring it with you to your appointment.

If you fill out the forms prior to your appointment you will need only to arrive at  our office 5 minutes prior to your appointment time.  

If you choose not to fill out the forms in advance, please plan to arrive at our office 30 minutes prior to the scheduled appointment time in order to complete the paperwork. 

In order to download the forms you must  have AdobeReader® installed on your computer.  If you do not already have AdobeReader® Click Here to download.


Notice Of Patient Privacy Policy


Complete New Patient Forms Online

Forms may be filled out using a computer, notebook or Ipad.  They cannot be filled out on and Android device or Iphone. 

An electronic signature is required at the end of the form before the form the can be uploaded. To sign the document simply write your signature in the box using your mouse or mouse pad. The signature cannot be typed in.

Fill Out New Patient Forms Online

                    

If you would like to Download & Print New Patient Forms  then fax to us before your appointment please send the  forms to us usiing the following fax number:

96th Street (317) 581-0209

You may also bring completed forms  with you to your appointment.

         


Member Wellness Registration Form 

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 office.  Click Here to register online! The online newsletter sign-up is also on the right. 



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Address

Convenient Northside Location

1305 W. 96th Street Suite C
Indianapolis, IN 46260

317-580-9867

Get Directions

THIS ---->https://chirowellnessindy.com/new-patient-center/online-forms.html

Office Hours

Our 96th Street office is convenient to north Indianapolis, Nora, Carmel, and Zionsville.

Chiropractic Office Hours

Dr. Mary Jo Johnson 

Monday Tuesday Wednesday Thursday Friday Saturday

10:30am-6:30pm

8:00am-4:00pm 10:30am-6:30pm 8:00am - 4:00pm

10:00am-3:00pm

*

Therapeutic Massage Hours

Becky Troyer, CMT

Monday Tuesday Wednesday Thursday Friday Saturday
10 am - 7:30 pm 11 am - 6:30 pm 11:30am-7:40pm 10:30 am - 6:30 pm - Closed.  


Marie Scott, CMT

Monday Tuesday Wednesday Thursday Friday Saturday
Out

1:20-7:30 pm

12:00-8:00 pm

Out

Out Closed

* Special appointment only.

Testimonials

Thank you Dr. Johnson - your gentle and holistic approach to chiropractic care and wellness is greatly appreciated. Your work and that of your wellness team is among the best!

R.D. Indianapolis
Indianapolis, IN

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