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100 Year Lifestyle Chiropractor in Brookfield WI
Phone: 414-482-5282
Make Your Health a Priority!

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Patient Forms

Health History

Please download these forms and complete them prior to your first visit. Bring the completed forms, with you and arrive for your appointment 15 minutes prior to your scheduled time. We look forward to seeing you!



Informed Consent



Health Care Authorization Form



Notice of Privacy Practices for Protected Health Information