Online Forms

Chiropractic & Wellness - New Patient Forms

Our new patient forms may be filled out online or they can be downloaded, printed, and filled out. Fax us your printed and completed form(s) or bring it with you to your appointment.

If you fill out the forms prior to your appointment you will need only to arrive at our office 5 minutes prior to your appointment time.

If you choose not to fill out the forms in advance, please plan to arrive at our office 30 minutes prior to the scheduled appointment time in order to complete the paperwork.

In order to download the forms you must have AdobeReader® installed on your computer. If you do not already have AdobeReader® Click Here to download.


Notice Of Patient Privacy Policy


Complete New Patient Forms Online

Forms may be filled out using a computer, notebook or Ipad. They cannot be filled out on and Android device or Iphone.

An electronic signature is required at the end of the form before the form the can be uploaded. To sign the document simply write your signature in the box using your mouse or mouse pad. The signature cannot be typed in.

We require all new patient forms to be filled in electronically.  If you are unable to complete the forms on line please plan to arrive 20 minutes earlier than your scheduled appointment time in order to complete forms in our office. 

Fill Out New Patient Forms Online




Download the Free AdobeReader®


Office Hours

Our 96th Street office is convenient to north Indianapolis, Nora, Carmel, and Zionsville.

Chiropractic Office Hours - Dr. Mary Jo Johnson

Monday:

10:30 am-5:30 pm

Tuesday:

9:00 am-4:00 pm

Wednesday:

10:30 am-5:30 pm

Thursday:

9:00 am-4:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Chiropractic Office Hours- Dr. Steve Avitabile

Monday:

7:00 am-9:00 am

Tuesday:

7:00 am-9:00 am

Wednesday:

7:00 am-9:00 am

Thursday:

7:00 am-9:00 am

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Therapeutic Massage Hours - Becky Troyer, CMT

Monday:

10:00 am-7:00 pm

Tuesday:

10:50 am-7:30 pm

Wednesday:

10:00 am-7:00 pm

Thursday:

9:00 am-6:00 pm

Friday:

Special appointment only.

Saturday:

Closed

Sunday:

Closed

Lily Rigby, CMT

Monday:

9:40 am-6:40 pm

Tuesday:

9:40 am-6:40 pm

Wednesday:

9:40 am-6:40 pm

Thursday:

Closed

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Kriss Luckett-Ziesemer, CMT

Monday:

Closed

Tuesday:

Closed

Wednesday:

Closed

Thursday:

9:40 am-6:30 pm

Friday:

10:00 am-4:30 pm

Saturday:

Closed

Sunday:

Closed

Location

Find us on the map

Testimonials

Reviews By Our Satisfied Patients

  • "Dr. Johnson is an amazing chiropractor and an amazing woman. Her staff is great, everyone is kind and there to be of service. Dr. Johnson will help you get your whole wellness life together, and will do it with kindness and care. I would send anyone here."
    Mr. K.
  • "Fantastic people doing great work in this office. I have had back pain since my mid-20's. The chiropractic work helped, but then Kurt was able to help me figure out I had a wheat intolerance that was the root cause of my problems. If you are looking for a great support system for your health needs, look no further!"
    Jeff C.
  • "I love this place!!!  I had never been to a Chiropractor before, i thought they were scary, with all the old school treatment.  Dr. Johnson is the best, her treatment plan has worked for me, i was a mess when i first went there, i suffered for months with the pain in neck, upper back and shoulders, starting the treatment on 5/25/2019.  i am so much better now!Her staff is also friendly and kind, and very knowledgeable, her front desk receptionist, Emily, is the best also!  Thank you all so much!"
    Kim K.
  • "Thank you Dr. Johnson - your gentle and holistic approach to chiropractic care and wellness is greatly appreciated. Your work and that of your wellness team is among the best!"
    R.D. Indianapolis /Indianapolis, IN