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Pediatric Forms

Dakota Chiropractic & Wellness Center 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 AdobeReaderĀ® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Bring the completed form(s) with you to your appointment or fax it to our office at 605-339-8880.

Pediatric New Patient Forms (ages 0 - 3 yrs)

This lets us know the history and current state of your infant's health.

You will need the following forms:

Pediatric History Form

Financial Policy

Location

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Office Hours

Our Regular Schedule

Monday:

8:00 am-1:00 pm

2:00 pm-5:30 pm

Tuesday:

8:00 am-10:30 am

2:00 pm-5:30 pm

Wednesday:

8:00 am-1:00 pm

2:00 pm-5:30 pm

Thursday:

8:00 am-10:30 am

2:00 pm-5:30 pm

Friday:

8:00 am-1:00 pm

2:00 pm-5:30 pm

Saturday:

Emergency

Sunday:

Closed