If you need a more accessible version of this website, click this button on the right. Switch to Accessible Site

WARNING

You are using an outdated browser. Please upgrade your browser to improve your experience.

Close [x]
H
H

651-777-3877

Exclusive Offer

Sign-up using the form or call us at
651-777-3877 to make your appointment

Polar Family Chiropractic Center offers our patient form(s) online so they can be completed 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 your printed and completed form(s) or bring it with you to your appointment.

New Patient Information and History Forms - 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 complete both forms.


Patient Information Form

Patient History Form

Auto Accident / Personal Injury / Work Comp Injury Forms - As They Apply

Please be as detailed as possible regarding the facts of your injury.  The more we know, the better we can assess whether your injury will respond favorably to chiropractic care.

Auto / Personal Injury Form

Work Comp Injury 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 office. You can print it out and bring it in to our office 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®

Testimonial

Dr. Mandel was able to alleviate both upper and lower back pain. In particular, he was successful in getting rid of a large knot near my left shoulder. I had been to several other chiropractors and physical therepists, and none of these professionals were able to help me. Dr. Mandel ranks far above any chiropractor I have ever had. I highly recommend him to anyone in need of chiropractic care and I do so without any reservation.

Judy - Hospital Safety Director (Retired) / MN

Office Hours

Day
Monday7:00-noon2:00-6:00PM
TuesdayClosedClosed
Wednesday7:00-noon2:00-6:00PM
Thursday8:30-noon2:00-6:00PM
Friday7:00-noonClosed
Saturday8-10AM By APPTClosed
SundayClosedClosed
Day
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
7:00-noon Closed 7:00-noon 8:30-noon 7:00-noon 8-10AM By APPT Closed
2:00-6:00PM Closed 2:00-6:00PM 2:00-6:00PM Closed Closed Closed