WARNING

You are using an outdated browser. Please upgrade your browser to improve your experience.

Close [x]

Godfrey Chiropractic PC 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.

Adult Health History

Download & Print Form


Automobile Accident

Download & Print Form


Pediatric New Patient Information

Download & Print Form


Newborn Health History 0 – 2 months

Download & Print Form


Infant Health History 2 months – 2 years

Download & Print Form


Pre-school Child History 3 – 5 years

Download & Print Form


School-age Child History 6 years and older

Download & Print Form



Download the Free AdobeReader®

Sign up using the form or call 402-331-0392 to make your appointment.

THIS ---->https://godfreychironet.chiromatrixbase.com/online-forms.html

Office Hours

DayMorningAfternoon
Monday9 - 13 - 6
Tuesday9 - 13 - 6
Wednesday9 - 13 - 6
Thursday9 - 13 - 6
Friday9 - 3
Saturday9 - 12
SundayClosedClosed
Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9 - 1 9 - 1 9 - 1 9 - 1 9 - 3 9 - 12 Closed
3 - 6 3 - 6 3 - 6 3 - 6 Closed

Testimonial

During and after my pregnancy, I've seen Bruce and Kate. I always feel like a new person after each visit. My daughter, age 2 has also been a client since she was an infant. I always recommend Godfrey chiropractic.

Bree C.
Omaha, NE

Newsletter Sign Up