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(812) 268-3400
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New Patients Accepted

WellnessFirst of Sullivan 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.

Patient Registration Form

  • You don't need to print out anything. Once you hit submit, it will get these straight to our secure portal and we will review it with you on your first visit! 
  • CAUTION: If at any point you hit ENTER it will submit it prematurely. Don't worry, just hit the back arrow and keep going until you hit the submit button. Just make sure to let out team know this happened when you arrive, so we can be sure we get everything. 

New Patient Registration Form - Print version 

If you would rather print out the forms and fill them out, just click the link. Just be sure to bring these with you on your first visit. 

Download & Print

*If you have been in a automobile accident, other personal injury or worker's compensation event, please come in to the office about 20 minutes before you appointment to fill out your paperwork. Sometimes these can be confusing and we want to be with you every step of the way! Contact our office for more information.


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



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Services

Services
We strive to provide complete care for our patients. Learn more about all the services we provide.
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Online Forms
Our patient forms are available online so they can be completed in the convenience of your own home or office.