Online Forms

Heartland Family Chiropractic, PLLC offers our patient form(s) online so they can be completed in the convenience of your own home or 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 Questionnaire - Required

Download & Print Form

Consent Form - Required

Download & Print Form

Intake Questionnaire - Required

Download & Print Form

Privacy Notice - Required

Download & Print Form

Patient Health Questionnaire - Required

Download & Print Form

Informed Consent Form - Required

Download & Print Form

Minor Consent Form - Required

Download & Print Form

Welcome Paperwork

Download & Print Form


Download the Free Adobe Reader®

Hours of Operation

Closed From 12-2pm Monday, Wednesday and Thursday

Monday

7:00 am - 5:30 pm

Tuesday

7:00 am - 12:00 pm

Wednesday

7:00 am - 5:30 pm

Thursday

7:00 am - 5:30 pm

Friday

7:00 am - 12:00 pm

Saturday

Closed

Sunday

Closed

Monday
7:00 am - 5:30 pm
Tuesday
7:00 am - 12:00 pm
Wednesday
7:00 am - 5:30 pm
Thursday
7:00 am - 5:30 pm
Friday
7:00 am - 12:00 pm
Saturday
Closed
Sunday
Closed

Our Location

  • Address

    1606 North Dixie Highway STE 111,
    Elizabethtown, KY 42701

HOURS
Mon, Wed, Thu 7:00 am - 5:30 pm
Tue, Fri 7:00 am - 12:00 pm
Sat Closed
Sun Closed
Closed From 12-2pm Monday, Wednesday and Thursday

Contact Us