Your First Visit
Please download the following forms and have them completed when you arrive for your first visit with the Prevention & Wellness Center, Inc. If you have any questions about these forms, please contact the office at (847) 984-6460. We look forward to seeing you on your appointment date.
Chiropractic Registration and History
(Click here for interactive version you can fill out on your computer, print and bring to the office)
Informed Consent for Examination and Treatment
Informed Consent to Participate in Active Rehabilitation
Additional forms if requested by physician:
These forms are provided in PDF format. To download, view, or print them, you'll need Adobe Acrobat Reader, version 5.0 or later. To ensure you have the latest version, please download the free Adobe Acrobat Reader software here.