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Patient Intake Forms

Click on the icons below to download our new patient forms as a PDF Document.

Once downloaded, print, fill in your information and bring with you to your next office visit. Your answers to these questionnaires will help to find the cause of your condition. Thank you for taking the time to complete them.

For everyone

Just for existing patients

Just for existing patients

PHI Consent info

For those with metabolic issues (thyroid, autoimmune, diabetes, etc)

Motor Vehicle Form

We are proud to serve the Tri-State area, including Evansville, Henderson and Southern Illinois

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Musculoskeletal Conditions
  • Headaches
  • Neck Pain
  • Low Back Pain
  • Carpal Tunnel
  • Tennis Elbow
  • Shoulder Pain
  • Rotator Cuff
  • Knee Pain
  • Plantar Fasciitis
Condition Specific Services
  • Diabetes
  • Thyroid / Hashimoto’s
  • Neuropathy / Foot Tingling
  • Anxiety / Stress / PTSD
  • Memory Loss
  • Fatigue
  • Brain Injury
  • Depression
  • Fibromyalgia
  • Insomnia / Sleep Issues
  • Learning Disabilities
  • Autism
  • Epilepsy / Seizures
  • Addiction
  • Stroke

Your Journey to a Healthier Life Starts Here

Are you ready to take control of your health and get the answers you are looking for?