New Patient Center

New Patient Forms Online

In an effort to save time at your first appointment, we have made new patient intake forms available online to fill out at your convenience. All of your personal information is transferred through a secure website and fully protected. You will need to have Adobe installed on your computer to view these forms.


Please remember to click the submit form button at the bottom of the page once you have completed the form. This ensures your forms are received by our office. You will also have the option to print the form for your own records. Once your forms have been submitted, we will receive them electronically in our office, so there is no need to print them for us.


Please note, our online forms will not submit on mobile devices. Please use a computer to complete your forms. 

Fill Out Your Forms Online

Aside from your new patient paperwork, on your first visit to Optimal Chiropractic, you will also need:

  • Your driver's license or photo ID

  • Your insurance card, if applicable

If you have any questions during this process, feel free to call our office at (217) 698-1111 for assistance.