New Patient Center
What will happen during the initial visit?
First, you will complete some health history forms and meet a doctor of the Servais Team. Your initial visit will include a review of your health history as well as an examination to assess orthopedic and neurological problems. If needed, x-rays or other diagnostic tests will be performed. We will then develop a personalized treatment plan designed to help you regain your health. If we don't feel that your condition will respond to chiropractic care, we will refer you to the appropriate specialist.
Servais Chiropractic Pain Relief Clinic offers our patient forms online so you can complete them in the convenience of your own home or office. Download the necessary forms, print them out, and fill in the required information.
Fax us your printed and completed forms or bring them with you to your appointment.
Fax: (920) 468-9785
New Patient Health History Form (105a) - Required
This provides us with your past medical history and current state of your health.
Functional Rating Index - Required for patients with neck and/or back symptoms.
This measures your current level of spinal pain and function.
Notice of Privacy Practices
We are committed to protecting your medical information. This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
No Surprises Act Notice
We are committed to transparency in pricing. This notice describes how we provide cost estimates for self-pay patients.
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