Northern Illinois Chiropractic Associates @
Healing Junction
About the Doctor
Forms
New Patient Forms:

New Patient Information

Consent to Treat

Bring completed forms with you to your first visit or fax to 773-880-9124 along with a copy of the front and back of your insurance card.


Privacy Information:

Privacy Information HIPPA

Other Forms:

Medical Records release to Healing Junction Chiropractic (Fill out and send to doctor where records are held)

Medical Records release from Healing Junction Chiropractic