Lighthouse Medical Group offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • Download the New Patient Health History Form, print it out and fill in the required information.
  • Fax us your printed and completed form at(630) 443-7351 or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Adult Patient Form

Adult Patient Form (Espanol)

Child Patient Form


Get Directions
 
Lighthouse Medical Group
525 Tyler Road Suite R1
St. Charles, IL 60174
Get Directions
  • Phone: 630-443-4411
  • Fax: 630-443-7351
  • Email Us

Business Hours

Day
Monday9-10:30 AM3-6:30 PM
TuesdayOPENby appt. only
Wednesday9-10:30 AM3-6:30 PM
ThursdayOPENby appt. only
Friday9-10:30 AMCLOSED
Saturday9-10:30 AMCLOSED
SundayCLOSEDCLOSED

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