New Patient Form

Welcome to Menner Chiropractic! 

Are you a new patient? Here’s how to prepare for your first visit with us, and get started with therapy. 

Getting Started Is Easy

We understand you might be apprehensive about your first chiropractic appointment. But from the moment you set foot in our office, you’ll feel like you belong at Menner Chiropractic. Our welcoming front office staff are happy to help you begin your path to wellness and answer any insurance, scheduling, or billing questions along the way.

When Should I Arrive?

Please arrive 15 minutes before your scheduled appointment time in order to complete all necessary paperwork. To save time, please complete the following form ahead of time.

Online Paperwork

To save time at your first visit, click and complete the following online form before your first appointment, and we’ll get you started even faster.


TO ALL NEW PATIENTS – Please fill out this secure New Patient form at least 24 hours prior to your visit:

Click here to fill out our online patient information form

    1. Click on the button above and fill out the secure form with as much information as possible  
    2. Sign the form with your mouse (click/hold button as you sign) then click the "submit" button
    3. Bring in any X-ray films, discs and X-ray/MRI/CT reports from within the past five years

Providing X-Rays

Please bring in any X-Ray / MRI / CT discs and/or reports that you have copies of. Our doctors are looking for any X-Ray / MRI / CT within the past 5 years.

Note: If you do not have copies, please contact the provider that has the information and have them fax it to Menner Chiropractic at (847) 277-8012 prior to your visit.

Proof of Insurance

Please bring your insurance card with you on your first visit. This will help us verify your insurance and provide you with the proper billing information.


Many patients feel immediate relief following chiropractic treatment, but it may take others two to three weeks before they achieve substantial progress. Many factors can affect the healing process. Are you suffering from a chronic problem or pain? Do you smoke? Are you following the recommended treatment plan? Usually, the more fully patients carry out the doctor’s recommendations, the better the results.

Learn More:

Facts and Information about Chiropractic Care

New Patient Guide

What We Treat


American Chiropractic Association
Illinois Chiropractic Society
National University of Health Sciences