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New Patient Paperwork

Chiropractic Touch offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them...
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

printerNew Patient Form #1 - Click Here to Download

 

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New Patient Form #2 - Click Here to Download

 

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Auto Accident Form - Click Here to Download

 

printerWork Injury Form - Click Here to Download

 

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Functional Rating Index - Click Here to Download

 

printerInfertility Questionnaire - Click Here to Download

Allergy Forms

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Allergy Questionnaire - Click Here to Download

 

printerAllergy History - Click Here to Download

 

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Planning Your Allergy Session - Click Here to Download

 

printerExplanation On How The Bax3000 Works - Click Here to Download

OFFICE HOURS
Monday8:30am - 6:00pm
TuesdayClosed
Wednesday8:30am - 6:00pm
ThursdayClosed
Friday8:30am - 6:00pm
SaturdayClosed
SundayClosed
Chiropractic St Charles IL Office Chiropractic Touch Logo

Chiropractic Touch
2560 Foxfield Road
St Charles, IL 60174
(630) 584-8729

Recommended Chiropractor

WHAT OUR PATIENTS SAY

Recommended Chiropractor - White

2560 Foxfield Road

St Charles, IL 60174