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100 Year Lifestyle Chiropractor in Brookfield WI
Phone: 414-482-5282
Make Your Health a Priority!

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Patient Forms

Adult New Patient Paperwork

Please print and bring with you on your first visit.



Child New Patient Paperwork

For ages 0-13. Please print and bring with you on your first visit.



Notice of Privacy Practices for Protected Health Information

Please review. This is a copy for your own records.