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Online Forms

We offer our paperwork on line so you can complete it in the convenience of your own home.


Adult Health History

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?

pdf iconDownload & Print Female Adult Form

pdf iconDownload & Print Male Adult Form


Child Health History

This let’s us know what’s happened with your child, or perhaps more important, where do you want your child’s health to be?

pdf iconDownload & Print Form for a Child 0-3 years old

pdf iconDownload & Print Form for a Child 4-8 year old

pdf iconDownload & Print Form for a Child 9-13 year old

pdf iconFinancial Policy – Download & Print Form


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Synergy Chiropractic & Wellness Center | (920) 757-6440

Quality chiropractic care for the Greenville, Appleton and Hortonville families.