New Patient Paperwork

Prior Lake Spine Health & Injury Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • New Patient Intake Form

    Click to Complete

  • Pediatric Intake Form

    Click to Complete

  • Patient Health Information Consent Form

    Click to Complete

  • Accident Injury Form

    Click to Complete

  • Massage Intake Form

    Click to Complete

  • Functional Rating Index

    Click to Complete

Clinic Information in Prior Lake

Patient Forms

Upon entering our office, we will request that you complete our patient forms located in the New Patient Center. This paperwork provides us with your health history and information on your specific condition. Save time by downloading forms here.


Next, you will have a consultation with the doctor to discuss your health-related problems, concerns, and potential treatment options. This initial visit is designed for Dr. Rickert to learn more about you, your condition, and expectations to determine if and how the care that we offer can meet your goals. Consultations are always complimentary!


After your consultation, Dr. Rickert will perform a complete chiropractic examination testing your reflexes and flexibility. Other standard neurological, orthopedic, postural, and physical tests may also be performed. However, nothing will be done in our office without your consent.

Recommended Action Plan or Report of Findings

Once the information is collected and examinations are performed, Dr. Rickert will give you a detailed report of all findings and answer any questions you may have.

After reviewing your health history, goals, and examining your spine, Dr. Rickert will discuss recommendations and notify you if your condition requires care with other providers. Dr. Rickert will provide the best treatment and wellness program for your needs.


At the conclusion of this initial appointment, you can choose to experience your first treatment. This may include spinal adjustments, physical therapy, and/or soft tissue massage. Treatment is interactive, so you can express concerns about the different styles of treatment anytime.


Most insurance plans are accepted at our office. We accept auto accident, workers compensation, personal injury and most health insurance plans, including Medicare. Since there are so many plans and coverage varies widely, please call us to find out if your plan covers care in our office. Our staff will verify and explain your benefits before treatment, at no charge.

No Insurance

For patients who have little or no chiropractic insurance coverage, flexible payment programs can be arranged. If you have no insurance or do not have chiropractic benefits there is still a way for you to receive the care you need. Many patients pay directly for care, as they discover chiropractic to be extremely cost-effective and affordable.


9:00am - 6:00pm

9:00am - 6:00pm

9:00am - 6:00pm

9:00am - 6:00pm

9:00am - 12:00pm

By Appointment


Short Term Relief Care
Same Day Appointments

Prior Lake
Spine Health & Injury Center

15815 Franklin Trail Southeast, #100
Prior Lake, MN 55372

(952) 226-5100