Duncan Chiropractic Health Center, llc

Duncan Chiropractic Health Center, LLC 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.

Chiropractic New Patient Paperwork

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!

This form MUST be filled out online before initial visit.

HIPPA Privacy Policy

Chiropractic Re-Exam Patient Paperwork

This re-exam updates your health status and allows us to establish a new plan of care. It also provides the documentation required by insurance to confirm medical necessity. 

This form MUST be filled out online before your re-exam visit.

Functional Medicine New Patient Paperwork

This form must be filled out and submitted before consultation

Functional Health History Form

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Duncan Chiropractic Health Center, LLC

Address

215 E. 22nd Street,
Fremont, NE 68025

Contact Us

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Please do not submit any Protected Health Information (PHI).

Office Hours

Holidays May Affect These Hours

Patient Treatment Hours

Monday  

9:00am - 1:00pm

2:30pm - 5:00pm

Tuesday  

9:00am - 1:00pm

2:30pm - 5:30pm

Wednesday  

9:00am - 1:00pm

2:30pm - 5:00pm

Thursday  

1:30pm - 5:00pm

Friday  

9:00am - 1:00pm

Saturday  

Closed

Sunday  

Closed