Online Forms

Superczynski Family Chiropractic, Ltd offers our patient form(s) online so they can be completed 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.


Personal and Family Health History Form

Download & Print Form


Chiropractic Active Life Plan Explanation Form

Download & Print Form


New Patient Health History Form

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!

Download & Print Form 
Download the Free AdobeReader®

Exclusive Offer

New patients receive 50% OFF first visit.

Office Hours

Our Regular Schedule

Monday:

8:00 am - 12:00 pm

3:00 pm - 7:00 pm

Tuesday:

Closed

Closed

Wednesday:

8:00 am - 12:00 pm

3:00 pm - 7:00 pm

Thursday:

Closed

3:00 pm - 7:00 pm

Friday:

8:00 am - 12:00 pm

3:00 pm - 7:00 pm

Saturday:

By Appt

Closed

Sunday:

Closed

Closed

Location

Find us on the map

Testimonial

Reviews By Our Satisfied Patients

  • "We value our patients' experience at Superczynski Family Chiropractic, Ltd. If you are currently a patient, please feel free to complete the following Client Experience Questionnaire. The Questionnaire is in Adobe Acrobat format, and requires the free Acrobat Reader to view.
    Download & Print Questionnaire"
    Dr. Steven S.

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