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All Spine Chiropractic and Wellness, LLC
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All Spine Chiropractic and Wellness, LLC

All Spine Chiropractic and Wellness offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • New Patients can fillout the necessary paperwork online after booking their first appointment using the url: Allspinechiro.janeapp.com
  • Established patients can fillout their intake forms through their online Jane portal: Allspinechiro.janeapp.com

New Patient Intake
​Paperwork

We look forward to helping you with your chiropractic needs!


Please help give us more information about your health history, current condition, and region of complaints.


(New patient includes those who have not been to our office in 3+ year)

Animal Chiropractic Veterinarian Referral Form

We'd love to help you with your animal chiropractic needs!


It is appropriate to have your veterinary to evaluate your beloved pet before you try chiropractic care.


New Injury Intake
​Paperwork

If you have a new injury or an exacerbation of a chronic condition, please give us a call.

We would love to help you!


We will need to block out a specific 30min time period to evaluate your new condition appropriately.



Motor Vehicle Accident
​Intake Paperwork

We look forward to helping you with your chiropractic needs!

Please help give us more information about your accident and current condition.






DOT Exam Paperwork

Lets get your ready for your DOT exam.

  • You will need a form of ID
  • List of current health conditions.
  • List of current medications.
  • List of surgical history
  • Driving glasses


DOT FMSA paperwork will be provided at the time of the appointment. 

Pediatric Intake Paperwork

We look forward to helping your child with their chiropractic needs!

Please help give us more information about their history and current condition.






Sport Physical

Lets get your ready for your student physical exam

  • List of current health conditions
  • List of current medications.
  • List of current vaccinations for school
  • List and dates of surgical history
  • List and dates of past injuries and interventions (P.T., brace, x-rays, MRIs, clearances, etc)
  • Students glasses

(Your school may provide the paperwork needed for the students sports physical.
Otherwise we do have copies if needed.)

New Patient/Service Inquiry

  • Please provide and email
  • Please provide a phone number
  • Please give us more information on the services you are interested in. We would love to help!
  • Terms & Conditions *

Call us today!
​913-914-7090

5931 Nieman Rd,
Suite 100
Shawnee, KS 66203

All Spine Chiropractic and Wellness, LLC