New Patient Paperwork

LifeSpine Health Enhancement Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer,
    Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring the necessary form(s) to your appointment.
  • New Patient Registration Form (STANDARD ADULT 18+)

    Click to Download

  • Pediatric Patient Registration Form (SCHOOL-AGED CHILD 5 – 17)

    Click to Download

  • Pediatric Patient Registration Form (NEWBORN TO PRE-SCHOOL)

    Click to Download

  • New Patient Registration Form (AUTO INJURY)

    Click to Download

OFFICE HOURS


Monday
9:00am – 6:00pm


Tuesday
9:00am – 7:00pm


Wednesday
9:00am – 6:00pm


Thursday
9:00am – 7:00pm


Friday
Closed


Saturday
Closed

LifeSpine Health Enhancement Center

4956 Benchmark Centre Drive Suite B
Swansea, IL 62226

(618) 622-9770