Health History

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use and why we need them.


Health History and Future

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?
 Download & Print Form


Work/ Automobile Accident

If your health issue is the result of a work or automobile related accident, we need some additional information.
 Download & Print Form


Free AdobeReader®

Each form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.

Call today to schedule your appointment.




Dr. John Wheeler| 316-618-5550
1125 S. Rock Rd #7, Wichita, KS

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Dr. John  Asks some important questions of interest to Wichita residents - Chiropractor Wichita Dr. John Asks...

Where do most Wichita residents get their first subluxation?
Being born in a hospital is a common source of subluxation. Trauma from forceps delivery has been replaced with drugs, vacuum extraction, Cesarean section and births that are "scheduled" to fit the workweek routines of Ob-Gyns. That's why we recommend a chiropractic checkup for every Wichita newborn.
What causes subluxations?
Chiropractors acknowledge three types of stress: physical, chemical and emotional. When the adaptive capacity of your body is compromised, weakened areas along the spine can become involved. Muscles tighten, spinal joints lock up and nearby nerves are affected. The purpose of chiropractic care is to find these areas and restore balance, alignment and motion.