New Patient Paperwork

LiveWell Chiropractic & Wellness Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

The following form(s) are to be done in addition to the standard patient intake.

  • The forms below 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.

OFFICE HOURS

Monday
8:00am - 7:00pm

Tuesday
8:00am - 7:00pm

Wednesday
8:00am - 7:00pm

Thursday
8:00am - 7:00pm

Friday
8:00am - 5:00pm

Saturday
9:00am - 11:00am

Sunday
Closed

LiveWell Chiropractic & Wellness Center

3456 Holiday Ct A
Bettendorf, IA 52722

(563) 332-7110