New Patient Paperwork

Active Life Family Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.
  • Pediatric New Patient Intake Form

    Click to Download

  • New Patient Intake Form

    Click to Download

Monday
7:30am - 6:00pm


Tuesday
7:30am - 10:30am


Wednesday
7:30am - 6:00pm


Thursday
7:30am - 6:00pm


Friday
7:30am - 11:30am


Saturday & Sunday
Closed

Monday
7:30am - 6:00pm


Tuesday
3:00pm - 6:00pm


Wednesday
7:30am - 6:00pm


Thursday
7:30am - 6:00pm


Friday
7:30am - 1:00pm


Saturday & Sunday
Closed

Monday
7:30am - 6:00pm


Tuesday
7:30am - 10:30am


Wednesday
7:30am - 6:00pm


Thursday
7:30am - 6:00pm


Friday
7:30am - 11:30am


Saturday
9:00am - 11:00am


Sunday
Closed

Active Life Family Chiropractic

Lincoln, NE

(402) 420-0440