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Online Forms

We offer our paperwork on line so you can complete it in the convenience of your own home.


Health History

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?

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Automobile Accident

If your health issue is the result of a car accident, we need some additional information.

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Worker’s Compensation

If your health issue is the effect of an injury at work, this information will help us help you.

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Free AdobeReader®

Each form is a PDF document file. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.


Thank you for the choosing to visit Midwest Chiropractic Care Center. Please give our Chicago chiropractic office a call if you have any questions or need help with the forms above.

Midwest Chiropractic Care Center | (773) 585-5550
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