Online Forms

Midwest Chiropractic Center offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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 Intake 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


Download the Free AdobeReader®


Midwest Chiropractic Center LLC
6104 Huntley Road
Columbus, OH 43229
Phone: 614-398-2635
Fax: 614-847-9688
Office Hours

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Peter Manz, DC
6104 Huntley Road
Columbus, OH 43229