Online Forms

Breidenbach Family & Sports Chiropractic 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.
  • Completed form(s) and bring it with you to your appointment.

New Patient Health History Form - 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!

Patient General Information

Patient Medical Information


If you have any questions about these forms or the information you need to provide, please feel free to contact any of our offices. We would be more than happy to answer any questions you may have about your chiropractic care at Breidenbach Family & Sports Chiropractic.



Office Hours

La Crosse North Office

Monday

8:30 AM - 6:00 PM - Dr. Ben

9:00 AM - 6:00 PM - Dr. Michelle

Tuesday

7:00 AM - 3:00 PM - Dr. Ben

12:00 PM - 6:00 PM - Dr. Michelle

Wednesday

7:00 AM - 6:00 PM - Dr. Ben

9:00 AM - 6:00 PM - Dr. Michelle

Thursday

8:30 AM - 12:00 PM - Dr. Ben

12:00 PM - 6:00 PM - Dr. Michelle

Friday

8:30 AM - 3:00 PM - Dr. Ben

9:00 AM - 6:00 PM - Dr. Michelle

Saturday

8:00 AM - 11:30 AM - Call for appointment

Sunday

Closed

La Crosse South Office

Monday

8:00 AM - 5:30 PM - Dr. Adam

Tuesday

8:00 AM - 5:30 PM - Dr. Adam

Wednesday

8:00 AM - 5:30 PM - Dr. Adam

Thursday

8:00 AM - 5:30 PM - Dr. Adam

Friday

8:00 AM - 5:30 PM - Dr. Adam

Saturday

8:00 AM - 11:30 PM @ La Crosse North

Call for appointment (once a month)

Sunday

Closed

La Crosse North Office

Monday
8:30 AM - 6:00 PM - Dr. Ben 9:00 AM - 6:00 PM - Dr. Michelle
Tuesday
7:00 AM - 3:00 PM - Dr. Ben 12:00 PM - 6:00 PM - Dr. Michelle
Wednesday
7:00 AM - 6:00 PM - Dr. Ben 9:00 AM - 6:00 PM - Dr. Michelle
Thursday
8:30 AM - 12:00 PM - Dr. Ben 12:00 PM - 6:00 PM - Dr. Michelle
Friday
8:30 AM - 3:00 PM - Dr. Ben 9:00 AM - 6:00 PM - Dr. Michelle
Saturday
8:00 AM - 11:30 AM - Call for appointment
Sunday
Closed

La Crosse South Office

Monday
8:00 AM - 5:30 PM - Dr. Adam
Tuesday
8:00 AM - 5:30 PM - Dr. Adam
Wednesday
8:00 AM - 5:30 PM - Dr. Adam
Thursday
8:00 AM - 5:30 PM - Dr. Adam
Friday
8:00 AM - 5:30 PM - Dr. Adam
Saturday
8:00 AM - 11:30 PM @ La Crosse North Call for appointment (once a month)
Sunday
Closed

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