Skip to content

There is No Risk to see what we can do for you

New Patient Paperwork

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

Chiropractic Intake Form

  • The forms below 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.

Massage Intake Form

Acupuncture Intake Form

OFFICE HOURS


Monday
9:00am - 7:00pm


Tuesday
8:00am - 6:00pm


Wednesday
9:00am - 7:00pm


Thursday
Closed


Friday
9:00am - 5:00pm


Saturday
Closed

LiveWell Chiropractic
& Wellness Center

3456 Holiday Court Suite A
Bettendorf, IA 52722
Phone: (563) 332-7110
Fax: (563) 332-7234

Scroll To Top