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Practice Name

DuPage Health & Wellness Center

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Primary Location
800 Roosevelt Rd Ste E220
Glen Ellyn, IL 60137
Phone: 630-469-527
Fax: 630-469-841

Office Hours

DayMorningAfternoon
Monday830-1230-7
TuesdayClosedClosed
Wednesday830-1230-7
Thursday830-1230-7
FridayClosedClosed
SaturdayClosedClosed
SundayClosedClosed
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Online Forms at DuPage Health & Wellness Center in Glen Ellyn

DuPage Health & Wellness Center offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

New Patient Health History Form - Download & Print

Low Back Questionnaire Form - Download & Print

Neck Disability Index Form - Download & Print


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our chiropractic office. You can print the form out and bring it in to our office during your next visit with our chiropractor, or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



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Online Forms

DuPage Health & Wellness Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.
Download Online Forms Here

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Our Services

We strive to provide complete care for our patients. Learn more about all the services we provide.

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Contact Us

DuPage Health & Wellness Center
800 Roosevelt Rd Ste E220
Glen Ellyn, IL 60137
Get Directions
 
  • Phone: 630-469-527
  • Fax: 630-469-841
  • Email Us

Office Hours

DayMorningAfternoon
Monday830-1230-7
TuesdayClosedClosed
Wednesday830-1230-7
Thursday830-1230-7
FridayClosedClosed
SaturdayClosedClosed
SundayClosedClosed
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