New Patient Paperwork

Clinton Back & Neck Family Wellness offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms 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.
  • Fax us your printed and completed form(s) or bring them with you to your appointment.

Monday
7:00am - 11:00am
12:30pm - 6:00pm


Tuesday
7:00am - 11:00am
12:30pm - 6:00pm


Wednesday
1:30pm - 6:00pm


Thursday
1:30pm - 6:00pm


Friday
7:00am - 11:00am
12:30pm - 6:00pm


Saturday's Open
7:00am - 10:00am
11/16, 12/7, 12/28

  • HALLOWEEN: Thursday, October 31st
  • THANKSGIVING: Thursday, November 28th - Saturday, November 30th
  • CHRISTMAS: Tuesday, December 24th & Wednesday, December 25th
  • NEW YEARS EVE: Close Early Tuesday, December 31st
  • NEW YEARS DAY: Wednesday, January 1st

Clinton Back & Neck Family Wellness
951 13th Avenue N
Clinton, IA 52732
(563) 242-5375