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Alpine Chiropractic 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.


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!

Download & Print Form


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form


Download the Free AdobeReader®
THIS ---->https://gaylordmichirocom.chiromatrixbase.com/new-patient-center/online-forms.html

Office Hours

DayMorningAfternoon
Monday6:30am1pm
Tuesday8am - 12:30pm2:30pm-5pm
Wednesday6:30am1pm
Thursday8am - 12:30pm2:30pm-5pm
Friday6:30am1pm
SaturdayClosedClosed
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
6:30am 8am - 12:30pm 6:30am 8am - 12:30pm 6:30am Closed Closed
1pm 2:30pm-5pm 1pm 2:30pm-5pm 1pm Closed Closed

If someone had told me 5 years ago that my back would feel as good as it does today I would not have believed them. My low back hurt every day because of standing on cement floors; loading the wood stove was a painful event. In 1992 I began going to chiropractors but still struggled with back pain. Then in 2010 I started getting my back adjusted by Dr. Puroll and I can't believe the difference, I can't believe how good it feels now. The Activator method has by far been the best for me..

Duane R.
Gaylord, MI

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