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618-254-1100 H
H

618-254-1100

First Visit Forms

visit_forms.pngPrime 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


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New Patient Health History & Wellness Assesment Form
Required for your first visit

Download & Print Patient History Form


om1.jpgInstructions:
  • 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.
  • Questions? Contact us at 618-254-1100 or

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.


Download the Free AdobeReader®

Exclusive Offer

New Patients Receive a Free Consultation.

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