(859) 858-0200

Pedersen Chiropractic PLLC

For prospective new patients, please click on the box for new patient complaint form which is the main application for treatment form. This form will provide us with information about you and your primary reason for seeking treatment in our office.

Please have this form completed when you arrive for your scheduled appointment!

The Additional complaint form allows you to add the needed information about additional areas of concern or complaints you would like us to address.

The HIPAA download provides our most recent iteration of our privacy policy.


X-Rays may be necessary prior to treatment. If you have prior imaging or test results pertinent to the complaint. please bring them with you to your appointment.

Additional imaging may be necessary, Clothing which does not have metal, buttons, zippers, patches or writing is usually suitable and may be more comfortable for you, otherwise X-Ray gowns will be available.