New Patient Paperwork

Total Balance Chiropractic offers our patient form(s) online so they can be completed in the convenience of your own home or office. Simply click on a link below to get started.

  • Adult Patient Intake Form

    Click to Complete

  • Pediatric Patient Intake Form

    Click to Complete

  • Informed Consent Intake Form

    Click to Complete

Monday
8:00am - 12:00pm
1:00pm - 7:00pm


Tuesday
8:00am - 1:00pm
4:00pm - 6:30pm


Wednesday
8:00am - 7:00pm


Thursday
8:00am - 1:00pm
2:30pm - 6:00pm


Friday
8:00am - 1:00pm


Saturday
8:00am - 1:00pm


Sunday
Closed


Accepting Same Day Appointments

Total Balance Chiropractic

3464 N Lincoln Ave
Chicago, IL 60657

(773) 348-6908