SIGN-UP USING THE FORM OR CALL US AT 651-777-3877 TO MAKE YOUR APPOINTMENT

Online Forms

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



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Office Hours

Our Regular Schedule

Monday:

7:00 AM - noon

2:00 PM - 6:00 PM

Tuesday:

Closed

Closed

Wednesday:

7:00 AM - noon

2:00 PM - 6:00 PM

Thursday:

8:30 am - noon

2:00 PM - 6:00 PM

Friday:

7:00 AM-noon

Closed

Saturday:

8:00 AM - 10:00 AM By APPT

Closed

Sunday:

Closed

Closed

Location

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