The Agape Chiropractic Center
118 South Milwaukee Avenue
Lake Villa, IL 60046
(847) 356-9696
Lake Villa, IL 60046
(847) 356-9696
Office Hours:
Monday, Wednesday & Friday: 9am-12 Noon; 2pm-6pm
Thursday: 2pm-6pm
"Fixing The Cause Not Just the Pain"
Updated June 1, 2009
Forms:
Please Click on the forms below and please print them out so you can have them filled out when you arrive at the office. Thank you.
1. Patient Intake Form
2. Consent Form
3. Application and Authorization for Treatment
4. Low Backpain Disability Questionnaire
5. Health History Record
Please Click on the forms below and please print them out so you can have them filled out when you arrive at the office. Thank you.
1. Patient Intake Form
2. Consent Form
3. Application and Authorization for Treatment
4. Low Backpain Disability Questionnaire
5. Health History Record
