---
title: Chiropractic Care Package Giveaway Form Template | Paperform
description: Run engaging chiropractic giveaway campaigns with this contest entry form. Collect pain assessments, wellness goals, and treatment interest to attract qualified patients and grow your practice.
url: "https://paperform.co/templates/chiropractic-care-package-giveaway"
type: static
generatedAt: "2026-03-28T00:43:18.502Z"
---

[← Back to free form templates](/templates/)    ![Chiropractic Care Package Giveaway](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/chiropractic-care-package-giveaway.png)
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### Win a Comprehensive Chiropractic Care Package

Are you living with back pain, neck discomfort, or chronic tension that's affecting your daily life? You're not alone—and relief might be closer than you think. Enter our chiropractic care package giveaway for a chance to experience natural, hands-on treatment that addresses the root cause of your pain, not just the symptoms.

This **Chiropractic Care Package Giveaway** form template makes it easy for chiropractic clinics to run engaging promotional campaigns that do more than just collect email addresses. By combining contest entry mechanics with a thoughtful pain assessment and wellness questionnaire, you'll attract qualified leads who are genuinely interested in improving their health—while building trust and demonstrating your expertise before they even walk through your door.

#### Why Chiropractors Need Smart Contest Forms

For chiropractic practices, patient acquisition often depends on breaking through skepticism and helping people understand what chiropractic care can actually do for them. A well-designed giveaway serves three goals at once:

 1. **Lead generation:** Attract new patients who are actively experiencing pain or mobility issues and are open to natural solutions
 1. **Education and trust-building:** Use the form to gently assess their condition, show you understand their challenges, and position chiropractic as a credible path forward
 1. **Qualification and follow-up:** Gather enough detail to personalize your outreach, whether they win or not, and invite them into your practice with relevant offers

This template collects essential information—pain location, injury history, treatment goals and wellness interests—so you can follow up intelligently and offer value even to non-winners through targeted content, consultations or introductory offers.

#### What Makes This Template Work

This form is structured to feel conversational and supportive, not clinical or invasive. It opens with a warm welcome and clear giveaway details, then moves through:

 - **Contact details** for entry and follow-up
 - **Pain and discomfort assessment** to understand where they're hurting and how it impacts their life
 - **Injury and treatment history** to gauge their familiarity with chiropractic and identify any contraindications
 - **Wellness goals** to learn what outcomes matter most to them—whether that's pain relief, mobility, posture, athletic performance or overall vitality
 - **Interest in ongoing care** to separate one-time curiosity from people ready to commit to a wellness plan

The language is approachable, empathetic and focused on the patient's experience, which helps drive higher completion rates and better-quality responses. Conditional logic can be layered in to tailor follow-up questions based on pain severity or treatment interest, and the design flexibility of Paperform ensures the form feels on-brand and professional—not like a generic survey.

#### Turn Entries Into Appointments with Stepper

Once submissions start rolling in, **Stepper** (stepper.io) can automate the entire post-entry workflow. For example:

 - Send a confirmation email thanking them for entering, along with a free guide to managing back pain at home
 - Tag and segment leads in your CRM based on pain severity, location or wellness goals
 - Trigger a follow-up sequence for non-winners offering a discounted first visit or free consultation
 - Notify your front desk when a high-priority lead (e.g., severe chronic pain) submits, so you can reach out personally
 - Update your email list and schedule them into a nurture campaign focused on chiropractic education and patient success stories

This means every contest entry becomes a qualified lead with a personalized next step, not just a name in a spreadsheet.

#### Perfect for Chiropractic Clinics, Wellness Centers and Health Campaigns

This template is ideal for:

 - **Chiropractic clinics** looking to grow their patient base with targeted local campaigns on Facebook, Instagram or Google Ads
 - **Wellness centers and integrative health practices** offering chiropractic as part of a broader holistic approach
 - **Sports medicine and physical therapy practices** adding chiropractic services and wanting to attract active, health-conscious patients
 - **Health and wellness brands** running co-marketing campaigns with chiropractors or promoting natural pain relief solutions

Whether you're launching a seasonal campaign (like "New Year, New You" wellness challenges), promoting a new clinic location, or simply looking to fill your appointment calendar, this template gives you everything you need to run a professional, compliant and high-converting giveaway.

#### Built on Paperform: Beautiful, Flexible, Ready to Convert

This template is built on **Paperform**, the flexible form builder trusted by over 500,000 teams worldwide. That means you can:

 - **Customize the look and feel** to match your clinic's branding with custom fonts, colors, background images and themes
 - **Embed it anywhere**—on your website, landing page, or Facebook tab—or share it as a standalone link
 - **Collect structured data** that flows straight into your CRM, email tool, Google Sheets or practice management software via native integrations or Stepper workflows
 - **Add conditional logic** to show different questions or success messages based on pain severity, treatment history or location
 - **Include scheduling fields** so winners can book their prize appointments directly in the form, syncing with your calendar in real time

Paperform is **SOC 2 Type II compliant and GDPR-ready**, so you can run campaigns confidently knowing patient data is secure and handled responsibly. Plus, with 30,000+ templates and an AI form builder, you can adapt this giveaway for different campaigns, services or specialties in minutes.

#### Launch Your Giveaway and Grow Your Practice

Chiropractors thrive when they can connect with people who are ready to feel better—and a well-executed contest is one of the fastest ways to make that happen. This template helps you attract the right leads, demonstrate your expertise and build relationships that turn into long-term patients.

Whether you're a solo practitioner or managing multiple clinic locations, Paperform and Stepper give you the tools to run campaigns that feel personal, professional and effortless behind the scenes. Start with this template, customize it to your practice, and watch your calendar fill with people who are excited to experience the benefits of chiropractic care.
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