1. Download**, Print, and Complete the appropriate form(s)

 2. Bring your completed paperwork to your appointment
     (If unable to print, please fax your completed form to us  502-326-9952)

PLEASE NOTE: If you are not to complete the appropriate forms prior to your appointment, please arrive 15 minutes before your appointment time.

**If you do not already have AdobeReader® installed on your computer, Click Here to download.     Download the Free AdobeReader®

Application for Care 
(Required for all adults unless pregnant)
Download & Print Form

Pregnant Patient Application for Care 

(Required if Pregnant)
Download & Print Form

Infant/Child & Adolescent Questionnaire
(Required for all children)

Download & Print Form

Personal Injury Form 
(Required for Motor Vehicle Accident)

Download & Print Form


Louisville Family Chiropractic
7300 New LaGrange Rd.
Louisville, KY 40222
Get Directions
  • Phone: 502-326-9950
  • Fax: 502-326-9952
  • Email Us

Office Hours

Monday9:00 - 1:003:00 - 6:00
Tuesday9:00 - 11:00Closed
Wednesday9:00 - 1:003:00 - 6:00
Thursday9:00 - 1:003:00 - 6:00

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