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New Patient Paperwork

Back 2 Health Chiropractic 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.
OFFICE HOURS
Monday9:00am - 1:00pm
3:00pm - 7:00pm
Tuesday2:00pm - 5:00pm
Wednesday9:00am - 1:00pm
3:00pm - 7:00pm
Thursday2:00pm - 6:00pm
Friday9:00am - 11:00am
SaturdayClosed
SundayClosed
Chiropractic Belleville IL Back 2 Health Chiropractic Logo

Back 2 Health Chiropractic
1820 North Belt East
Belleville, IL 62221
(618) 233-4458

Recommended Chiropractor

WHAT OUR PATIENTS SAY

Recommended Chiropractor - White

1820 North Belt East

Belleville, IL 62221