New Patient Forms | Chiropractor in Schaumburg & Wheaton, IL

BEFORE YOUR FIRST VISIT

Welcome! If you’re planning your first visit to My Natural Health Center, we look forward to meeting you. To save time on your first visit, we encourage you to fill out our new patient form below.

Please click the button to download the New Patient Form (digital). This will open the PDF viewer, but MAKE SURE you download it before filling it out (down arrow in top right). Then, fill it out by typing in the form fields and using the drop-downs and checkboxes. Make sure to save your completed form and upload it below by attaching the file, typing in your name and hitting the "submit" button.
If you are unable to fill out the digital form, please download the New Patient Form (print) and fill it out with neat handwriting. You may upload and submit your completed form and/or bring it with you to your appointment.
Make sure to submit digitally or bring your completed form so you can make the most of your time with Dr. Shostek!