New Patient Paperwork

Kabir Center for Health offers our patient forms online so they can be completed in the convenience of your own home or office.

  • Chiropractic New Patient Paperwork (Ages 14 Years & Up)

    Click to Complete

  • HIPAA Consent Form (Ages 14 Years & Up)

    Click to Complete

  • Chiropractic Pediatric History Form (Ages 0-13 Years)

    Click to Complete

  • HIPAA Consent Form (Ages 0-13 Years)

    Click to Complete

  • SoftWave Patient Intake Form

    Click to Complete

  • EmSculpt NEO Patient Intake Form

    Click to Complete

  • Emsella Patient Intake Form

    Click to Complete

  • Cellutone Patient Intake Form

    Click to Complete

Monday
7:00am - 12:00pm
2:00pm - 6:00pm


Tuesday
9:00am - 1:00pm


Wednesday
7:00am - 12:00pm
2:00pm - 6:00pm


Thursday
7:00am - 12:00pm
2:00pm - 6:00pm


Friday
By Appointment

Kabir Center For Health
2412 East Washington Street #9A
Bloomington, IL 61704
(309) 663-7011

McLean County Chamber of Commerce