Online Forms

Kennedy Chiropractic offers our patient form online so it can be completed at your convenience. Simply download the PDF (you’ll need AdobeReader if you don’t already have it), print and complete the form, and bring it with you to your appointment. You can also fax us the form at 309.762.4645.

New Patient Health History Form - Required

Our New Patient Health History Form informs us about your medical history and what symptoms you are seeking treatment for. Let us know what questions, concerns or goals you have and how we can help improve your overall level of wellness.

Download & Print Form