Online Forms

Online Patient Forms
Arctic Chiropractic offers our patient form(s) online, so they can be completed in the comfort of your own home or office. 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!


1. Download the necessary form, print it out and fill in the required information.

Chiropractic New Patient Intake
Physical Therapy New Patient Intake
Consent to treat a Minor
Massage Referral New Patient Intake
Existing Patient Massage Intake
Massage Therapy Referral Form
Physical Therapy Referral Form

2. Fax us your printed and completed form(s) or bring it with you to your appointment.

About Us



Phone: (907) 416-4094
Fax: (907) 313-6812

2243 Jordan Ave Juneau , AK 99801

Hours of Operation

Monday to Saturday
7:00 am - 6:00 pm

By Appointment Only