Schmidt Chiropractic is now certified through the NRCME to perform DOT physical exams for truck, bus and commercial motor vehicle drivers.

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In Network provider for all major insurance programs.

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Schmidt Chiropractic Center is a full service chiropractic office which offers total healthcare from chiropractic care and massage therapy to ear candling, acupuncture and nutritional guidance.

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Feel free to contact our office regarding any questions that you may have regarding chiropractic care and how we can help you or your family.

Chiropractic New Patient Medicare & Medicaid Forms



Please print all the forms below and complete them in their entirety and arrive 10 minutes prior to your appointment.  Your initial Exam and any extremity adjustments are not a covered benefit for Medicare and Medicaid patients.  You are required to pay at time of service for the initial exam and any extremity adjustments.  However the adjustment will be billable to your health insurance.  We realize this may not seem completely clear to you, so please do not hestiate to call us with any questions or concerns.  We'd be happy to answer any questions you may have.  Thank you! 



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Admit Form

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Health History Questionnaire
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Neck Pain Index
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Back Pain Index
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Consent for Chiropractic Treatment & HIPPA Notice

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Medicaid Patients Only - Clinic Financial Policy
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Medicare Patients Only - Clinic Financial Policy

320 E Hill St, PO Box 215
Norwood Young America, MN 55368
Phone: (952) 467-2505
Fax: (952) 467-9104

SchmidtChiroCenter@gmail.com