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Online Forms

Gilcher Chiropractic Life Center offers our patient form(s) online so they can be completed it 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, and then fill in the required information.
  • Fax to us your printed and completed form(s) or bring it with you to your appointment.

Laser Therapy Form

Download & Print Form



New Patient Adult Health Form  

This lets us know your history and current state of health. Which questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form


New Patient Child - Under 18 Health Form  

Download & Print Form


 Privacy Practices Notice 

Download & Print Form


Patient Centered Medical Home (PCMH)

Download & Print Form



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Locations

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Office Hours

Our Regular Schedule

Monday:

9:30am - 1:00pm

3:00pm - 7:00pm

Tuesday:

Closed

Closed

Wednesday:

9:30am - 1:00pm

3:00pm - 7:00pm

Thursday:

Closed

Closed

Friday:

9:30am - 1:00pm

3:00pm - 7:00pm

Saturday:

By Appointment

Closed

Sunday:

Closed

Closed