Casper Chiropractic
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Casper Chiropractic
  • Home
  • Scheduling
  • Jasper
  • Bloomington
  • About
  • We help with...

Patient Portal

Please utilize the following links at the interval in parenthesis to facilitate your visit.



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Check in (Each Visit)
Scheduling (as needed)
New Patient (1st Visit)

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2023 Financial and Treatment Consent Form (Once per year)
2023 Acupuncture Consent Form (Once/year)
2023 Medicare ABN Form (Once/Year)

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2023 JHS Athletics Consent Form
Beta Check IN

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

Also consider leaving a review on Google.  Not happy with how you are being treated? Leave some feedback. Constructive criticism is how we grow and improve!


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Bloomington Review
Jasper Review
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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)

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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.

Copyright © 2023 Casper Chiropractic - All Rights Reserved.

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Are you happy with how you are being treated? Take a minute to leave a review....Not happy? Give some feedback on how to improve. Constructive criticism is how we grow. 

Leave a review or feedback