New Patient Paperwork

Complete Health 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.
  • Fax us your printed and completed form(s) or bring them with you to your appointment.

Paying for your care here is easy!

No Insurance

Easy! Our Care Plans and simple payment arrangements have helped over hundreds of people and will work great for you too!

Health Insurance

  • These days, insurance pays very little if anything for natural drugless care to get you healthy. So we make it easy!
  • We will verify any benefits you may have and send your claims in to your insurance for you.
  • If they pay anything after your deductible is met, we will accept payment directly from them.
  • You are responsible for any deductible, co-insurance, co-pays and unpaid visits.
  • Of course you can use your HSA, HRA, and Flex dollars here!
  • For your convenience, all payment arrangements are made in advance. We will never surprise you with a bill in the mail.

Auto Injury

  • Auto related injuries are covered on an individual basis. Even if you were at fault you will usually have benefits through your personal car insurance! Our team is experienced in handling all types of cases and can help you get the care you need whatever your situation.

Work Injury

  • Work injuries can be covered 100% up to 12 weeks of care.
  • It costs you nothing
  • All we need is your claim number and Work Comp ins. info.


  • Medicare pays for much of your care making it quite easy.
  • We simply need a copy of your Medicare card.

You have made a great decision to get care here!

Our goal is to be your family’s chiropractor for life!


9:30am - 12:00pm
3:00pm - 6:00pm

9:30am - 12:00pm
3:00pm - 6:00pm

9:30am - 12:00pm
3:00pm - 6:00pm

9:30am - 12:00pm
3:00pm - 6:00pm



Complete Health Chiropractic
3037 Village Square Drive
Hartland, WI 53029
(262) 367-9340