Iron River: (906) 265-9000 Crystal Falls: (906) 874-0111
© 2021 Northwoods Family Chiropractic Iron County Michigan. Website by North Country Website Design
Northwoods Family Chiropractic - Iron River Address: 202 W. Adams St​; Iron River, MI 49935 Office Phone: (906) 265-9000 | Fax: (906) 265-9009 Hours: Monday: 7am - 12pm, 1pm - 4:30pm Tuesday: 7am - 12pm Wednesday: 7am - 12pm, 1pm - 6pm Thursday: CLOSED Friday: 7am - 12pm, 1pm - 4:30pm
Northwoods Family Chiropractic - Crystal Falls Address: 328 Superior Avenue; Crystal Falls, MI 49920 Office Phone: (906) 874-0111| Fax: (906) 874-0112 Hours: Monday: 7am - 11am, 12pm - 4pm Tuesday: CLOSED Wednesday: 7am - 11am, 12pm - 4pm Thursday: CLOSED Friday: 7am - 11am, 12pm - 4pm






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Northwoods Family Chiropractic

New Patient Forms

Northwoods Family Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office before you arrive to our clinic. Allow yourself 15-20 minutes to complete the forms. Please fill out each section completely, selecting "none" if a section doesn't apply to you or "other" if your answer is not listed. When you are finished, please print the forms and bring them with you to your first visit.

Adult

Assignment of Health Plan Benefits and Rights Authorization for Release of Medical Information Informed Consent Patient Health Questionnaire Patient Intake Form Acknowledgement of Receipt of Notice of Privacy Practices Notice of Patient Privacy Policy

Infants and Toddlers

Assignment of Health Plan Benefits and Rights Pediatric Authorization for Release of Medical Information Informed Consent Infant Health Questionnaire Permission To Treat A Minor Acknowledgement of Receipt of Notice of Privacy Practices Notice of Patient Privacy Policy

School-aged Child

Assignment of Health Plan Benefits and Rights Pediatric Authorization for Release of Medical Information Informed Consent School-Age Health Questionnaire Permission To Treat A Minor Acknowledgement of Receipt of Notice of Privacy Practices Notice of Patient Privacy Policy

Weight Loss

New Patient Questionnaire for Weight Loss Informed Consent Acknowledgement of Receipt of Notice of Privacy Practices
Next Page: About Us - Meet Our Staff Next Page: About Us - Meet Our Staff New PatientCenter
Iron River: 906-265-9000 | Crystal Falls: 906-874-0111
© 2021 Northwoods Family Chiropractic Iron County Michigan. Website by North Country Website Design
Northwoods Family Chiropractic - Iron River Address: 202 W. Adams St​; Iron River, MI 49935 Office Phone: (906) 265-9000 | Fax: (906) 265-9009 Hours: Monday: 7am - 12pm, 1pm - 4:30pm Tuesday: 7am - 12pm Wednesday: 7am - 12pm, 1pm - 6pm Thursday: CLOSED Friday: 7am - 12pm, 1pm - 4:30pm
Northwoods Family Chiropractic - Crystal Falls Address: 328 Superior Avenue; Crystal Falls, MI 49920 Office Phone: (906) 874-0111 | Fax: (906) 874-0112 Hours: Monday: 7am - 11am, 12pm - 4pm Tuesday: CLOSED Wednesday: 7am - 11am, 12pm - 4pm Thursday: CLOSED Friday: 7am - 11am, 12pm - 4pm






Which location works best for you?


What day works best for you?


What time works best for you?





Northwoods Family Chiropractic

Next Page: About Us - Meet Our Staff Next Page: About Us - Meet Our Staff

New Patient Forms

Northwoods Family Chiropractic offers our patient forms online so they can be completed in the convenience of your own home or office before you arrive to our clinic. Allow yourself 15-20 minutes to complete the forms. Please fill out each section completely, selecting "none" if a section doesn't apply to you or "other" if your answer is not listed. When you are finished, please print the forms and bring them with you to your first visit.

Adult

Assignment of Health Plan Benefits and Rights Authorization for Release of Medical Information Informed Consent Patient Health Questionnaire Patient Intake Form Acknowledgement of Receipt of Notice of Privacy Practices Notice of Patient Privacy Policy

Infants and Toddlers

Assignment of Health Plan Benefits and Rights Pediatric Authorization for Release of Medical Information Informed Consent Infant Health Questionnaire Permission To Treat A Minor Acknowledgement of Receipt of Notice of Privacy Practices Notice of Patient Privacy Policy

School-aged Child

Assignment of Health Plan Benefits and Rights Pediatric Authorization for Release of Medical Information Informed Consent School-Age Health Questionnaire Permission To Treat A Minor Acknowledgement of Receipt of Notice of Privacy Practices Notice of Patient Privacy Policy

Weight Loss

New Patient Questionnaire for Weight Loss Informed Consent Acknowledgement of Receipt of Notice of Privacy Practices
New PatientCenter