Client Intake Forms

Thanks for your interest in coming to the Chiropractic Wellness Cafe. Please choose the form download that is most applicable to you and bring it with you. Remember that you must schedule an appointment before showing up the first time. 


Thank you and be sure to contact us if you have any questions. 

Adult Intake

Pregnancy Intake Form

Pediatric Intake Form

New Clients

If you would like to get started now, click below to open a copy of our entrance forms, print them out, fill them in, and bring them with you to the office. It’s as easy as that!

Newsletter Signup

Sign up here for classes, special events, office hour changes and more!


Once upon a time in the land of Tarrant county I was pregnant with número tres and began having ‘lots of pain in my pubic bone area. My Doula suggested I see a chiropractor, and recommended Dr. Rac...

- Kacie P.
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