8 S. Michigan Ave.
Suite 1420
Chicago, IL 60603
(p) 312-258-1338
(f) 312-873-1115
info@chicagoinh.com

Patient Forms

Before your first appointment, please download and fill out these forms. Please bring them with you to your first appointment.

 

Chiropractic / Physical Rehab Intake:  If your chief complaint is pain related or has to do with an injury, please print out the following this form.

Naturopathic / Nutrition Intake:  If your chief complaint is related to nutrition, chronic illness, digestive health, etc, please print out the following form. 

30 Minute Nutritional Consultation Intake:  If you have scheduled a 30 minute nutritional consultation, please print out the following form.

Massage Therapy Intake:  If you have scheduled a massage therapy session, please print out the following form. 

Chicago Institute of Natural Health - Licensed under Creative Commons Attribution 3.0