Patient Forms


New Patient Registration Forms

These forms let us know what’s happened, but perhaps more important, where do you want to take your health?

Chiropractic Client Intake Form

Secure File Transfer

Download the Informed Consent Form

Download Patient Welcome Letter and Registration Form

Download Patient History Form

Download Pediatric Case History Form


Region Specific Questionnaires

These forms help us determine how much your condition is affecting your ability to perform activities of daily living.

Download the Back Pain Index

Download the Neck Pain Index

Contact Us

Send Us An Email Today!

Locations in Berlin and Omro

Find us on the map

Office Hours

Find Out When We Are Open

Dr. Michael Bosquez DC, CCEP

Monday:

Omro 7:30 am – 6:00 pm

Tuesday:

Berlin 8:00 am - 5:30 pm

Wednesday:

Omro 7:30 am – 6:00 pm

Thursday:

Berlin 8:00 am - 5:30 pm

Friday:

Omro 7:30 am – 1:00 pm

Saturday:

Closed

Sunday:

Closed

Dr. Mitchell D. Kramer DC

Monday:

Berlin 8:00am - 6:00 pm

Tuesday:

Omro 8:00 am - 5:00 pm

Wednesday:

Berlin 8:00am-6:00 pm

Thursday:

Omro 8:00 am - 5:00 pm

Friday:

Berlin 7:300 am - 1:00 pm

Saturday:

Closed

Sunday:

Closed