The Canton Chiropractor to see - Chiropractor Canton

Online Forms

We offer our paperwork on line so you can complete it in the convenience of your own home. 

New Patient

This let’s us know what’s happened, but perhaps more important, where do you want to take your health? Questions? Give our Canton office a call.

 

 Download & Print Form

Automobile Accident

If your health issue is the result of a car accident, we need some additional information.

 Download & Print Form

Worker’s Compensation

If your health issue is the effect of an injury at work, this information will help us help you.

 Download & Print Form

 

Patient Update

If you have not been in the office for more that a year please fill this form out and bring it in.

  Download & Print Form

 

Personal Injury

  Personal Injury Questionnaire.pdf

  Personal Injury Questionnaire 2.pdf

Free AdobeReader®

Each form is a PDF document file.  If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.



Dr. Randy & Dr. Tyson Klinedinst
103 South Main Street
Canton, IL
Phone: (309) 647-8030
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Dr. Klinedinst Asks some important questions of interest to Canton residents - Chiropractor Canton Dr. Klinedinst Asks...

Will chiropractic adjustments make my spine too loose?
No. Only the spinal joints that are fixated and "locked up" receive attention. The occasional spinal joint that moves too much is passed over so weakened muscles and ligaments can strengthen and heal.
Why do so many drugs require a prescription?
Because they can be dangerous? I chose a chiropractic career specifically because it avoids artificial means of pain relief. Our Canton chiropractic practice attracts health-conscious families that prefer a safe and natural solution. Ready to get started? Call our office today.