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New Patient Forms

We've made it easy for you to fill out paperwork. Simply download the appropriate intake form, print off, fill out and bring it in with you to your first visit. Questions? Call us at (815) 223-0647 and we will be happy to help.

Adult Intake Form

Download here

Child Intake Form

Download here

Office Hours
Office Hours

Monday           9am - 12pm, 2 - 6pm
Tuesday          2 - 6pm
Wednesday     9am - 12pm, 2 - 6pm
Thursday         Closed
Friday              9am - 12pm, 2 - 5pm
Saturday         Closed
Sunday            Closed

Existing Patient Portal

Gergovich Family Chiropractic, Back Pain, Migraines, LaSalle IL Chiropractor, Car Accidents

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a new patient appointment

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