New Patient Center

Online Forms

White Eagle Health and Wellness Inc. offers our patient form(s) online so you can complete it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

 

Chiropractic Registration and History Form

Download the Form here

Patient’s Signature on File for Medical Claims Form

Download the Form here

Acknowledgement of Receipt of Notice of Privacy Practices Form

Download the Form here

Consent to Treat a Minor Form

Download the Form here

 

Client testimonials

I’ve been a patient of Dr. Chris’ chiropractic services for several years. He created a post-op personalized care program for me, and during regular visits, he has helped me get relief from my chronic pain symptoms. I have seen Dr. Chris for pain related to a total shoulder reconstruction to a sprained ACL and have been extremely satisfied with the level of care I received. I highly recommend Dr. Chris as a chiropractor if you are looking for a personable, honest, hard working physician. December 4, 2012, Michelle was Dr. Christopher’s client

Michelle Geltner – Marketing Coordinator at Crawford, Murphy & Tilly, Inc.

Dr. Chris is a perfect example of what it means to listen. He delivers results to his clients based on his profound knowledge of the human body. His impeccable ability to provide treatment based a patient’s needs, past history and preferences is exemplary. December 4, 2012, Anne was Dr. Christopher’s client

Anne Taft – Yoga Instructor, Posture Alignment Specialist, Broga® Yoga Instructor

Dr. Chris is gifted at what he does. After playing in the NFL for four years as a linebacker, I know a good chiropractor when I see one. Dr. Chris is exactly that and highly skilled at getting your body to feel and run at the most optimal level possible. December 5, 2012, J was Dr. Christopher’s client

J. Leman – Ruby Director at USANA Health Sciences Inc.

For those of us who have been to see a chiropractor, I am sure we have all experienced the doctor who does the quick adjustment and you are out the door with your bill. Dr. Chris is the furthest from this concept that I have ever experienced. He consistently spends a great deal of time working problem areas with deep massage therapy in addition to the adjustment. He works out of his office in Naperville. I have probably a hundred options for chiropractors between here and there, but I will continue to drive 45 minutes to see him because he is just that good. September 11, 2013, Delores was Dr. Christopher’s client

Delores Brittain – Probation Officer at Will County Adult Probation

Dr. Chris has been providing me EXCELLENT treatment to keep my body tuned, top to bottom, allowing me to remain physically active as a 50 year old. Dr Chris is extremely knowledgable, and is highly effective in applying situational care for unique needs to address my body recovery as well as prescribing proactive maintenance routines that truly, truly work for me. I HIGHLY recommend Dr Chris and completely trust his advice and care. December 3, 2013, Larry was Dr. Christopher’s client

Larry Williford – PMO Lead, Program Manager at ADT

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