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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. 

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.

At Allen Chiropractic, we promote complete wellness and natural healing. True wellness does not come in the form of a pill or bandage. Your own body has the ability to heal itself but may need assistance in getting that process started. This is where Allen Chiropractic steps in.  Dr. Daryl Allen takes the time to discover the underlying cause of your problem and understands how to begin the healing process with chiropractic.

Dr. Allen enjoys helping entire families with chiropractic. Starting chiropractic care early prevents problems from arising later in life. And if you have ignored your body’s warning signals and are already experiencing problems, Dr. Allen can still make positive changes to your life. It is never too late to start chiropractic. Experience healing and true wellness for life with Allen Chiropractic.
3315 Robbins Road, Springfield, IL 62704 | 217-698-1111 | movethebone@yahoo.com
© 2017 Dr. Daryl M. Allen | All Rights Reserved