Printable Forms

Godfrey Chiropractic PC 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.

Adult Health History

Download & Print Form


Automobile Accident

Download & Print Form


Pediatric New Patient Information

Download & Print Form


Newborn Health History 0 – 2 months

Download & Print Form


Infant Health History 2 months – 2 years

Download & Print Form


Pre-school Child History 3 – 5 years

Download & Print Form


School-age Child History 6 years and older

Download & Print Form



Download the Free AdobeReader®

Exclusive OfferSign up using the form or call 402-331-0392 to make your appointment.

Office Hours

Our Regular Schedule

Monday:

9:00 am-1:00 pm

3:00 pm-6:00 pm

Tuesday:

9:00 am-1:00 pm

3:00 pm-6:00 pm

Wednesday:

9:00 am-1:00 pm

3:00 pm-6:00 pm

Thursday:

9:00 am-1:00 pm

3:00 pm-6:00 pm

Friday:

9:00 am-12:00 pm

Saturday:

by appt only

Sunday:

Closed

Closed

Location

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Testimonial

Review By Our Satisfied Patient

  • "During and after my pregnancy, I've seen Bruce and Kate. I always feel like a new person after each visit. My daughter, age 2 has also been a client since she was an infant. I always recommend Godfrey chiropractic."
    Bree C. /Omaha, NE

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