Welcome to our family!

Congratulations on taking the first step toward a healthier, wellness-based lifestyle. As a new addition to our family, we ask that you complete the following forms. If you have any questions while completing the forms, please do not hesistate to contact our office at 262-723-2739 for assistance.

Adult Practice Members

Download
Adult Practice Member Health Record
For our adult practice members.
Member_Health_Record-Adult_10-07.pdf
Adobe Acrobat document [461.7 KB]
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Cancellation Policy
At Apex Family Chiropractic each practice member is very important to us. Your appointment time is reserved just for you and its vital to your care that you attend every scheduled appointment!
cancellation policy.html
HTML document [23.7 KB]
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Our Privacy Copy (READ ONLY)
This is a copy of our privacy policy, you do not need to print this form, please just read through the policy. A copy is available in our office if you would like one.
hippawebsite.html
HTML document [14.5 KB]

Child Practice Members, Pages 1 & 2

Download
Child Member Health Record Page 1
For all new practice member children, this page is required.
Child Member Health Record-Page 1 07-10.[...]
Adobe Acrobat document [37.1 KB]
Download
Child Member Health Record Page 2
For all new practice member children, this page is required.
Child Member Health Record-Authorization[...]
Adobe Acrobat document [49.6 KB]

Child Member Health Record Ages 9-13

Download
Ages 9-13
Please complete these additional forms for children ages 9-13.
Child Member Health Record- Age 9-13 Pag[...]
Adobe Acrobat document [37.8 KB]

Child Member Health Record Ages 4-8

Download
Ages 4-8
Please complete these additional forms for children ages 4-8.
Child Member Health Record- Age 4-8 Page[...]
Adobe Acrobat document [38.1 KB]

Child Member Health Record Ages 0-3

Download
Ages 0-3
Please complete these additional forms for children ages 0-3.
Child Member Health Record- Age 0-3 Page[...]
Adobe Acrobat document [38.4 KB]