614 S. 225th

Des Moines, WA 98198 US

(206) 878-2225

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Online Forms

Today's Chiropractic Clinic offers our patient form(s) online so you can complete it 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 Health History Form - *Required

This let's 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

Terms of Acceptance Form - *Required

Download & Print Form

Payment Types Form - *Required

Download & Print Form

Symptom Survey (optional, but recommended, if you would like a nutritional consult)

Download & Print Form

Pediatric Treatment Form (*Required for Children)

Download & Print Form

Massage Therapy Forms - Insurance, Auto/Work injury

Download & Print Form



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Sign-up using the form or call us at (206) 878-2225 to make your appointment today!

Office Hours

Our Regular Schedule

Monday:

8:30 am-12:00 pm

2:30 pm-6:30 pm

Tuesday:

8:30 am-12:00 pm

2:30 pm-5:00 pm

Wednesday:

8:30 am-12:00 pm

2:30 pm-6:30 pm

Thursday:

Out of Office

Out of Office

Friday:

8:30 am-12:00 pm

2:30 pm-6:30 pm

Saturday:

Out of Office

Out of Office

Sunday:

Out of Office

Out of Office

Locations

Find us on the map

Testimonials

Reviews By Our Satisfied Patients

  • "Thank you for 15 years of chiropractic care! Ever since coming to you I have experienced better posture and instant relief from headaches and back pain. I can't thank you and Dana enough for your positive, caring and personal attention to my total health!""
    Rocky M. Des Moines, WA

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