Online Forms

SFC Wellness Center offers our patient form(s) online so they can be completed 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 - Adult Chiropractic

Fill-Out Form


New Patient - Child Chiropractic

Fill-Out Form


New Patient Intake Form - Personal Injury

Fill-Out Form


New Patient Intake - Weight Loss

Download & Print Form


New Patient Intake - Gut Health

Download & Print Form


New Patient Intake - Neuropathy

Download & Print Form

Patient Quality Of Life Survey - Download & Print Form


Download the Free Adobe Reader®

CONTACT US TODAY

We look forward to hearing from you

Location

Find us on the map

Office Hours

Our Regular Schedule

Bettendorf Office

Monday:

8:00 am-10:00 am

3:00 pm-6:00 pm

Tuesday:

3:30 pm-5:30 pm

Wednesday:

8:00 am-10:00 am

3:00 pm-6:00 pm

Thursday:

Closed

Friday:

8:00 am-10:00 am

3:00 pm-6:00 pm

Saturday:

Closed

Sunday:

Closed