Meylor Chiropractic offers our patient form(s) online so they can be completed 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 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!

Pediatric Form

meylor chiropractic
Dr. Wayne R. Meylor, D.C
400 Plymouth St. S.W., Le Mars, IA, 51031
Monday - Wednesday:
8:30 AM - 12:30 PM and 2:30 AM - 6:00 PM

8:30 AM - 12:30 PM
Walk-ins Welcome!
© 2021 Meylor Chiropractic Clinic,  All Rights Reserved