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Online Forms

Defiance Chiropractic Center offers our patient form(s) online so you can complete it in the convenience of your own home or 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.

Patient Update Form

This form is for our existing patients. You can print and complete this form prior to your first visit of the new year.

Download & Print Form


New Patient Health History Form - Required

This let's 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


 Youth Health History Form - Required for patients under 18 years old.

Downolad & Print Form



Download the Free AdobeReader®

Location

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Office Hours

Our Regular Schedule

Monday:

8:30 am-7:30 pm

Tuesday:

8:30 am-5:00 pm

Wednesday:

8:30 am-5:00 pm

Thursday:

8:30 am-7:30 pm

Friday:

8:30 am-5:00 pm

Saturday:

8:30 am-12:00 pm

Sunday:

Closed

Testimonials

Reviews By Our Satisfied Patients

  • "Defiance Chiropractic Center is a quality organization willing to give back to the community!"
    Jess R.
  • "All the Doctors are fantastic! I recently saw Dr Kemper and my back feels sooo much better! Thanks Doc!"
    Megan M.
  • "Great Doctors and staff! My entire family sees Dr. Klingler even our children and grandchildren. Dr. Klingler is specialized in pediatric care. Wouldn't go any place else."
    Brenda S.