New Patient Paperwork

Lukowski Family Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.

  • Introduction Patient Case History

    Click to Download

  • Pediatric Questionnaire

    Click to Download

  • Accident Injury Questionnaire

    Click to Download

  • Privacy Policy

    Click to Read

OFFICE HOURS

Monday
10:00am - 1:00pm
3:00pm - 6:30pm

Tuesday
10:00am - 1:00pm
3:00pm - 6:30pm

Wednesday
10:00am - 1:00pm
3:00pm - 6:30pm

Thursday
10:00am - 1:00pm
3:00pm - 6:30pm

Friday
Closed

Saturday
Closed

Lukowski Family Chiropractic

34529 Utica Road
Fraser, MI 48026

(586) 285-1090
Awards