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Reinforce Health & Wellness

Chiropractic - Acupuncture - Prenatal Care - Pediatric Care - Sports Rehab - Therapeutic Massage

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Intake Forms

  • Home
  • New Patient
  • Intake Forms

Please Print and fill out the following paperwork

 

Chiropractic Appointment

Intake Paperwork

HIPPA

Cancellation policy

Consent to Treat

Visual Analog Scale

SHoulder disability index

Neck Disability Index

Oswestry

Acupuncture Appointment

Acupunture Intake

Acupuncture Consent to treat form

Reinforce Health & Wellness, P.C.

636 E. Irving Park Road, Roselle, IL 60172
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  • Phone:630-893-4000
  • Fax: 630-893-4001
  • Email: reinforcehealth@gmail.com
Office Hours

Monday : 8:00am-7:00pm
Tuesday: 8:00am-7:00pm
Wednesday : 8:00am-7:00pm
Thursday: 8:00am-7:00pm
Friday: 8:00am-7:00pm

Saturday: 8:00am-12:00pm

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