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Workers Compensation 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.

Workers Compensation New Patient Forms

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

You will need the following forms:

Patient Information Form

Workers Compensation Questionnaire

Back Index Form

Patient Health Questionnaire

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