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Online Forms

Please fill out the following forms then print them and bring them to your appointment. (*Note if you are over the age of 8 please print the adult history and if you are 8 or younger print the pediatric history form.)

This lets us know the history and current state of your health. What questions, concerns, or goals regarding wellness can we help you with? Let us know!


New Patient Health History Form - (Required)

Adult History (9 years old and up)

Pediatric History (8 years old and younger) 

Robin Wellness Center offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us (763-746-1246) your printed and completed form(s) or bring it with you to your appointment.

Functional Index Rating - (Required)

Functional Index Rating


Robin Wellness Center offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.


Medical Symptom Toxicity Questionaire - (Required)


Robin Wellness Center offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.


Download the Free AdobeReader®

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Office Hours

Our Regular Schedule

Robin Wellness Center

Monday:

8:00 am-11:30 am

3:00 pm-6:00 pm

Tuesday:

Closed

3:00 pm-6:00 pm

Wednesday:

8:00 am-11:30 am

3:00 pm-6:00 pm

Thursday:

8:00 am-11:30 am

3:00 pm-6:00 pm

Friday:

By Appointment Only

By Appointment Only

Saturday:

Closed

Closed

Sunday:

Closed

Closed