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Online Forms

Coulee Chiropractic Clinic offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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 Health History Form - Required

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

Download & Print Form



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Location

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Office Hours

Our Regular Schedule

Chiropractic Appointments Hours

Monday:

8:00 am-5:00 pm

Tuesday:

8:00 am-2:00 pm

Wednesday:

8:00 am-5:00 pm

Thursday:

Closed

Friday:

8:00 am-5:00 pm

Saturday:

Closed

Sunday:

Closed

Testimonials

Reviews By Our Satisfied Patients

  • "I had a wonderful experience, as a first time patient. Dr. Charity is so caring, she has a great skills as a Chiropractor. I m feeling better already. Definitely recommend."
    Sandy, La Crosse, WI
  • "Dr. George is a consummate and compassionate professional. She has helped me with a number of back issues, and referred me to a neurologist who helped with migraine issues. She also recognized issues with my vertebrae, referring me to a neurosurgeon for that. I appreciate her connections to the health networks in town, and taking a “big picture” look at my health and wellness."
    Adam J. Jacobi
  • "I love going to Dr. George office. Very welcoming. I always leave there feeling better."
    Joanne Balfanz Seymour