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Stange Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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 Intake Form

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!

Download & Print Form


Pediatric Intake Form

Download & Print 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 chiropractic office. You can print the form out and bring it in to our office during your next visit with our chiropractor, 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



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Exclusive Offer

Sign up now for a free consultation!

THIS ---->https://stangechiropracticcom.chiromatrixbase.com/online-forms.html

Office Hours

Day Morning Afternoon
Monday 8:30am 5:30pm
Tuesday 8:30am 5:30pm
Wednesday 8:30am 5:30pm
Thursday 8:30am 6:00pm
Friday Closed Closed
Saturday Closed Closed
Sunday Closed Closed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
8:30am 8:30am 8:30am 8:30am Closed Closed Closed
5:30pm 5:30pm 5:30pm 6:00pm Closed Closed Closed

Testimonial

I have benefited tremendously from the chiropractic care I received from Dr. Stange.

Bob H.
Orange City, IA

I love Chiropractic care because it helps keep my kids healthier!

Jamie S
Orange City

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