New Patient Paperwork

Midtown Chiropractic Clinic 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
Monday 9:00am - 5:15pm
Tuesday 9:00am - 5:15pm
Wednesday 9:00am - 5:15pm
Thursday 9:00am - 5:15pm
Friday Closed
Saturday Closed
Sunday Closed

444 North Henderson Street
Galesburg, IL 61401

highly recommended