City Lakes Chiropractic
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To request a massage appointment please complete the information below.
Please complete the appointment information below and click the submit button when you are finished.
If you have any questions, please call 612-722-2147 or email to appointments@citylakesclinic.com
First Name
Last Name
Request appointment for:
Massage Only Appointment Request
If needed, Please contact me at the following email addrss:
Email Address
Retype Email Address
*if you have had an insurance change or no longer have insurance please provide us with your most current information at your visit. We have affordable self pay options available if you do not have insurance coverage
please double check your email is typed correctly
Day
Month
Date
View Calendar
Additional notes or questions
Preferred Time
2nd Option
3rd Option
please note we try to schedule your appointment as close to your preferred tine as possible
Take a look at what others are saying about City Lakes
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Save time and complete your paperwork before your appointment!
Click on the file below to complete your initial intake form. Simply print your forms, fill them out and bring them to your appointment.
