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Back Into Life Chiropractic offers our patient form(s) online so you can complete it in the convenience of your own home or office.

  • Complete Intake Form online and simply click submit
  • We will have all of your information then saved in our database and we'll be ready upon your arrival.

New Patient Health History & Patient Privacy Forms - Required

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

Complete Intake Form Online

Download & Print Patient Privacy Form

Download the Free AdobeReader®

Exclusive Offer

Now accepting new patients. Schedule an initial examination with us!

Sign-up using the form or call us at 763-712-5986 today!

THIS ---->https://backintolifechiro.com/new-patient-center/online-forms.html

Office Hours

Monday Tuesday Wednesday Thursday Friday Saturday Sunday
7:30am 7:30am 7:30am 7:30am 7:30am Closed Closed
6:00pm 6:00pm 6:00pm 6:00pm 3:00pm


They certainly live up to their name! My husband and I have a significant improvement in our quality of life and it is all due to their caring and competent staff. My husband had a work related injury that could have kept him out of work for months or even required surgery, but thanks to all the staff at Back Into Life he was back to work in a month. They always put the customer first and I'm continuously amazed at how efficiently they assess what's wrong and fix it! You truly could not find a better place for chiropractic care.

Ramsey, MN