Jasper, Indiana

New Patient? Please click the link. Established Patient? Please use the links at the recommended interval.

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New Patient (1st visit)

Check in (Each Visit)

Scheduling (as needed)

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2023 Financial and Treatment Consent Form (Once per year)

2023 Medicare ABN Form (Once/Year)

2023 Acupuncture Consent Form (Once/Year)

Jasper Athletics

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Prior to your appointment, please be sure to change into the appropriate apparel for your specific region of complaint(s).

Appropriate apparel
- T-shirt for Upper Extremity, Neck, and Upper Back Complaints
- Shorts and Bare Feet for Lower Back and Lower Extremity Complaints.
Restrooms are available for changing.

Outcome Assessment Tools

To track progress and to satisfy insurance guidelines, please complete the applicable form(s) below related to your primary and/or secondary complaint at your first visit of the month. Compliance may affect insurance coverage.

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NECK AND UPPER BACK (Once/month)

Mid to Low Back and Pelvis (once/month)

Upper Extremity (once/month)

Lower Extremity (once/month)

Are you happy with how you are being treated? Let others in Jasper know.

Also consider leaving a review on Google.

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Jasper Review

Not happy with how you are being treated? Let us know.

Constructive criticism is how we grow and improve.

Contact Us

Active Chiropractic and Rehabilitation

209 3rd Avenue, Jasper, Indiana 47546, United States

812-301-2088.

Hours

Today

By Appointment