New Patient Paperwork

LifeSource Health and Wellness offers our patient form(s) online so they can be completed it 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.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.
Monday 8:00am - 12:00pm
3:00pm - 6:30pm
Tuesday 3:00pm - 6:00pm
Wednesday 8:00am - 12:00pm
3:00pm - 6:30pm
Thursday 8:00am - 11:00am
3:00pm - 6:30pm
Friday Out of Office
Saturday Closed
Sunday Closed

1136 Bloomingdale Road
Glendale Heights, IL 60139

highly recommended