New Patient Paperwork

Smith Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring them with you to your appointment.

OFFICE HOURS


Monday
8:30am - 5:00pm


Tuesday
8:30am - 5:00pm


Wednesday
8:30am - 5:00pm


Thursday
8:30am - 12:00pm


Friday
8:30am - 4:30pm


Saturday
Closed

Smith Chiropractic
14015 Jamestown Road
Breese, IL 62230
(618) 526-7732