Prime Health Family and Sports Chiropractic Wellness Center offers our first visit forms here so you can complete them in the convenience of your own home or office.
- Save time
- More convenient
- More comfortable
New Patient Health History & Wellness Assesment Form
Required for your first visit
Download & Print Patient History Form
Instructions:- Download the necessary forms, print them out and fill in the required information.
- Fax us your printed and completed forms or bring them with you to your appointment.
- If you do not already have AdobeReader® installed on your computer, Click Here to download.
Questions? Contact us at 618-254-1100 or Email Us
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Contact
Prime Health Family and Sports Chiropractic Wellness Center
234 E. Ferguson Ave.
Wood River, IL 62095
Get Directions
234 E. Ferguson Ave.
Wood River, IL 62095
Get Directions
- Phone: 618-254-1100
- Fax: 618-254-1100
- Email Us