Accessibility View Close toolbar

Online Forms

Lemont Natural Healthcare offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

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

1. Chiropractic Registration Form(2 pages) - Required

Download & Print Form


2. New Patient Intake Form(2 pages) - Required

Please complete one intake form for EACH area of complaint.

Download & Print Form


Choose from one of the following, or complete both if you are experiencing back AND neck pain.- Required

3a. Back Pain Questionnaire

Download & Print Form

3b. Neck Pain Questionnaire

Download & Print Form


4a. Personal Injury - Motor Vehicle Accident Intake Form - Page 1

Download & Print Form

4b. Personal Injury - Motor Vehicle Accident Intake Form - Page 2

Download & Print Form


Download the Free AdobeReader®

Contact Us Today

We look forward to hearing from you

Locations

Find us on the map

Office Hours

Our Regular Schedule

Primary Office

Monday:

9:00 am-12:00 pm

3:00 pm-7:00 pm

Tuesday:

By Appt. Only

Wednesday:

9:00 am-12:00 pm

3:00 pm-7:00 pm

Thursday:

By Appt. Only

Friday:

9:00 AM-12:00 pm

3:00 pm-7:00 pm

Saturday:

By Appt. Only

Sunday:

Closed