Schedule Online    402-261-5766

Electronic Intake Paperwork

Fletcher Chiropractic is pleased to offer our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive at our chiropractic office.

Please click HERE to fill out our intake paperwork online.

If you have any questions or concerns regarding wellness, please let us know!

Once you click submit, your information will be automatically downloaded into our system.

 

Notice of Privacy Practices Policy (No need to print off, but please read.)

 

New Patient Health History For for children

Download and Print Form for Children under 5

Download the Free AdobeReader®

 

Contact

Fletcher Chiropractic
Phone: 402-261-5766
Fax: 402-261-5943

Lincoln Location
4300 S 48th St Suite 7
Lincoln, NE 68516

Valparaiso Location
208 W 2nd St
Valparaiso, NE 68065

Office Hours

After Hours til 7 and Saturday Appts. Available
.............. Lincoln ............
Monday - Wednesday8AM – 5:30PM
Thursday8AM – 12PM
Friday8AM – 4:30PM
Saturday/SundayBy Appt/Closed
.............Valaparaiso........
Tuesday1PM – 6PM
Thursday2PM – 6PM

Testimonials

I stopped doing things I enjoyed, like working out.  I felt limited in my activities and sleeping was becoming an issue with my neck pain.Following treatment: Its so much better. I can workout, take long ...
I am very active but hampered by lower back pain.  It prohibited me from participating in firefighter training.Following Treatment:  I am back to doing everything I love without the restriction of pain. Fletcher Chiropractic taught ...
I was in a mental fog.  I couldn't think or concentrate and was not doing well.Following acupuncture treatment: I am much better. My mind is clear and my work performance has improved. Julie A.
Being from a small town, I love mom and pop shops.  I like the personal level and hands-on approach that Fletcher Chiropractic takes when it comes to chiropractic care. Fletcher Chiropractic was very personable and ...
Life was manageable.  As a runner, I was able to run without issue, but not without tightness and occasional pain.  Throughout the day, perhaps 2-3 days a week, my knee, calf, and shin experienced significant ...
I experienced chronic pain in my right foot from heel spurs.  Orthotics were not enough to correct the problem.  After 6 months of not sleeping well and associated problems of fatigue, I sought help at ...
Life was very painful.  I never felt good and medications really have not helped.Following Treatment: I am much improved but I still recognize my limitations and I need to make more lifestyle changes to make ...
My pain has been with me since 1996 and my feet and legs were totally painful.  Walking is like walking on glass or nails and then the burning pain in my toes would start.Following acupuncture ...
Life was good but my condition was bad.  I lead a very active lifestyle with weightlifting, judo, etc and along with my job, the pressure on my back was incredible.  My movement was restricted and ...
Working with Dr. Kadi has changed my life. Before going to her, I was stiff and had pain in my neck, back, hips, legs and feet.Following Treatment: Working problem areas and doing exercises she has ...
prev next
read more