NEW PATIENT INTAKE FORM
Welcome...

If you are a new patient at Lake Geneva Chiropractic, please click on the “New Patient Intake Form” link and fill out the information.  When you are finished, please click submit.

Your Chiropractic care is customized just for you.  There is no need for pre-paid Chiropractic care packages.  If you have any questions please feel free to call 262-248-8177 with any questions. 

Congratulations, you’re on your way to being healthier and pain-free!
Jeffrey Buntrock, D.C.
Brad Christensen, D.C.
 

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Types of Payment Accepted

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612 Wells Street Suite C
Lake Geneva, WI 53147
262-248-8177
Monday 
Tuesday
Wednesday
Thursday
Friday
Saturday
8:30 - 7:00
9:00 - 7:00
8:30 - 7:00
9:00 - 6:00
8:30 - 5:30
8:30 - 11:00 
Insurance / Managed Care Plans Accepted
Aetna
Blue Cross
Cigna
First Health Coventry
Health E.O.S.
Humana
Medicaid / Forward Health
Medicare
PHCS
The Alliance
Trilogy
United Health Care