Patient Forms — Download & Complete Before Your Visit
Save time on your visit! Download and complete these forms before your appointment.
Save Time—Fill Out Your Forms Before You Arrive!
We want to spend more time focused on getting you feeling better and less time on paperwork. Download and complete your forms ahead of time, and you'll be ready to go when you arrive. It's quick, easy, and helps us give you the best care possible!
General New Patient Form
This comprehensive form collects important information about your health history, current symptoms, and treatment goals.
Required for: All new patients seeking chiropractic care
Time to complete: 10-15 minutes
📥 Download PDFPediatric New Patient Form
Specialized form for children 12 and under including prenatal history, birth information, and developmental milestones.
Required for: Pediatric patients (12 and under)
Time to complete: 15 minutes
📥 Download PDFPersonal Injury / Auto Accident Form
Specific information needed if you're seeking treatment after an auto accident or work-related injury. Includes accident questionnaire and health care lien.
Required for: Accident/injury patients
Time to complete: 15-20 minutes
📥 Download PDFMassage Therapy Only Form
For patients seeking massage therapy services only. Includes health history, areas of concern, and massage-specific consent forms.
Required for: Massage therapy patients
Time to complete: 5-10 minutes
📥 Download PDFWhich Form Do I Need?
- General New Patient Form: Most adult patients seeking chiropractic care should download this form.
- Pediatric Form: If your child is 12 years old or younger, download this specialized pediatric form instead.
- Personal Injury / Auto Accident Form: If you were injured in an auto accident or work-related injury, download this form in addition to the general form.
- Massage Therapy Only Form: If you're only seeking massage therapy services (not chiropractic), download this form.
How to Complete Your Forms
- Download the appropriate form(s) by clicking the download buttons above.
- Print and complete the forms using a pen with black or blue ink. Please write legibly.
- Bring to your appointment or email completed forms to absolute@awellnesscentre.com at least 24 hours before your visit.
- Don't have a printer? No problem! Arrive 15 minutes early to complete forms in our office.
Frequently Asked Questions
What should I bring to my first appointment?
Bring your completed forms, photo ID, insurance card (if applicable), and a list of any current medications or supplements you're taking.
Can I fill out forms digitally?
Yes! You can fill out PDF forms on your computer or tablet, then print and sign them. Or email the completed forms to us.
What if I don't complete the forms beforehand?
That's okay! Just arrive 15 minutes before your scheduled appointment time to complete the paperwork in our office.
Do I need to complete forms for every visit?
No, these forms are only required for your first visit. We'll ask you to update information periodically or if anything changes.
Is my information secure?
Absolutely. We follow strict HIPAA guidelines to protect your privacy and keep all your health information confidential.
Do I need to fill out patient forms before my first chiropractic appointment?
Yes. New patients at Absolute Wellness in Peoria, IL are asked to complete intake forms before their first visit. You can download and fill them out in advance from our website to save time at the office. Forms can be brought to your appointment or emailed to absolute@awellnesscentre.com at least 24 hours before your visit.
What information is required on the new patient intake form?
The new patient intake form at Absolute Wellness asks for your personal contact information, health history, current symptoms, medications, and insurance details. Completing this in advance allows Dr. Kelch to review your history before your appointment and spend more time on your examination and treatment.
Can I fill out patient forms online before my visit?
Yes. Patient intake forms for Absolute Wellness in Peoria, IL are available to download from this page. Complete them at home and bring them to your appointment, or email them to absolute@awellnesscentre.com at least 24 hours ahead of your scheduled visit.
What should I bring to my first chiropractic appointment in Peoria?
For your first visit at Absolute Wellness, bring your completed patient intake forms, a valid photo ID, your insurance card, and a list of any current medications. If you have recent X-rays or MRI results related to your condition, bring those as well. Arrive 10–15 minutes early if you have not completed your forms in advance.
Ready to Schedule Your Appointment?
New Patient Special: $49 (Consultation, Exam, X-rays if needed & First Adjustment)