New Patients

Patient Forms

Please complete all required forms before your first visit.

All three forms are required before your first visit.

You must complete the HIPAA Consent, the Financial Policy Agreement, and the New Patient Intake Forms. Treatment cannot begin until all three are on file.

Complete all three steps below

Step 1 of 3 - Required

Patient Health Information (HIPAA) Consent

Authorizes Wheat Chiropractic & Wellness Center to use your patient health information for treatment, payment, and healthcare operations.

Step 2 of 3 - Required

Financial Policy Agreement

Outlines payment responsibilities, insurance billing procedures, and financial agreements between you and Wheat Chiropractic & Wellness Center.

Step 3 of 3 - Required

New Patient Intake Forms

Complete your new patient paperwork securely online through our patient portal. This includes your health history, chief complaint, and intake questionnaire.

Complete Forms Online

Questions? Call us at 573-636-3555 or email wheatchiro@outlook.com