Freeport Family Chiropractic & Acupuncture offers our patient form(s) online so they can be completed in the convenience of your own home or office.
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If you do not already have AdobeReader® installed on your computer, Click Here to download.
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Download the necessary form(s), print it out and fill in the required information.
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Fax us your completed form(s) or bring them with you to your appointment.
Our fax is (815) 233-3379
New Patient Health History / HIPPA / Insurance Forms – Required