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Practice Name

West Michigan Chiropractic Center

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Primary Location
6475 Belding Rd. NE
Rockford, MI 49341
Phone: 616-874-2225
Fax: 616-874-2229

Office Hours

DayMorningAfternoon
Monday8am - 12pm3pm - 6pm
Tuesday9am - 12pm3pm - 6pm
Wednesday8am - 12pm3pm - 6pm
Thursday8am - 12pm3pm - 6pm
FridayClosedClosed
SaturdayBy Appt
SundayClosedClosed
Main Content

West Michigan Chiropractic Center 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.

New Patient Health History Forms - Required

This lets 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 and Print Here

For children under 12 please also complete the Pediatric Case History form below.

Children Under 12


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our chiropractic office. You can print the form out and bring it in to our office during your next visit with our chiropractor, or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



Download the Free AdobeReader®

EXCLUSIVE OFFER!!

New to the office?? We would like to give you a FREE Consultation**

Sign-up using the form or call us at 616-874-2225 to take advantage of this exclusive offer.

Name: *
Email: *
Phone: *
**does not include x-rays, exam or adjustment

Our Services

Services We strive to provide complete care for our patients. Learn more about all the services we provide. Make An Appointment We will do our best to accommodate your busy schedule. Schedule an appointment today! Online Forms Our patient forms are available online so they can be completed in the convenience of your own home or office.

Testimonial

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