New Patients
New Patients
Please download and complete the following form before your first appointment. In addition, please bring your driver's license, insurance card and a copies of any medical reports or images related to your complaint.
Welcome to our office. At your first appointment we will take a comprehensive health history; complete an examination of the primary complaint and establish the causes of the condition. Appropriate diagnostic testing may include: X-Ray; MRI, Nerve Conduction studies and lab work.
At your second appointment, you will receive a customized treatment plan developed by your physician. Periodic assessments and modifications to chiropractic treatment plans ensure continued improvement. The length of your treatment varies dependent upon the complaint and the severity of the presenting issues.
You are an integral to your treatment plan. Your compliance to your treatment plan and therapies will have a significant impact on your improvement. Patients who attend all recommended appointment and complete their recommended exercises and therapies have significantly improved outcomes.
Additional Patient Forms
Returning Patients
If you have been to our offices in the past three years and have a new complaint, please download and complete the following form before your exam. Please bring your insurance card and copies of any medical reports or images completed since your last visit to our offices.
ReExam
Print this form and complete before your Re-Exam
Workman's Compensation
Workplace injuries and auto accidents have a significant impact upon your quality of life. The information collected on these forms can help your doctor develop a treatment plan that is effective in reducing your pain. Please complete the following form, in addition, please bring in copies of any documentation from the accident as well as copies of any medical reports or images related to your injuries.
Personal Injury
If you injury is related to an auto accident or a slip and fall, please print and complete this form. In addition please bring in any supporting documentation including police reports, medical reports or images that are related to your injury.
HIPPA Release For Friends and Family
Use this form to give our staff permission to share healthcare and billing information with friends and family.
Medical Release of Information
Use this form to allow the release of your medical information between health care providers.
Location
350 W. Kensington Rd. #102
Mount Prospect, IL 60056
Our hours
M, W, Th, F 9am – 1 pm
M, T, W, Th 3pm – 7 pm
Contact us
Phone: 1 847 222 9060
Email: info@apmt.us