New Patient Paperwork

Congratulations, you have made the first step to improving your life and being healthier with our Winnebago IL chiropractors. Above you will find a history form. A chiropractic case history is a little different from any other history you have ever filled out. We believe that God made an amazing body. We were born "almost perfect," but throughout our lives we accumulate layers of injury. These layers could be physical, mental or chemical. This history will help us to better understand your layers of injury and give you the opportunity to tell us about your current health concerns. It starts with your birth process, your childhood, and your current health today. If there are answers you do not know, please leave them blank. Use the comments section to give us any additional information.

On your first visit, the doctor will do a detailed case history review to obtain all the information necessary for your case. Then the doctor will perform a complete spinal physical exam and if necessary, take x-rays. On your second visit, there will be a video presentation on x-rays to help you understand normal and abnormal x-rays. This will help you understand your x-rays when the doctor shows them to you. The doctor will then give you a written report of findings on your history, exam, and x-rays and make an appropriate recommendation for your case. After you will make a decision about the recommendations, you will begin your care.

When you come for your visit please bring your paperwork fully filled out and your insurance card (if you would like us to check your coverage.) We look forward to helping you and your family. If you have any questions before your visit please call (815) 335-1381.

Welcome to our family practice. We will give you our very best.