First Health Associates offers some of our patient form(s) online so that they can be completed 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.

New Patient Forms

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Patient Registration Form
Medical History Intake Form




Family Medicine

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Age Specific Screening


Wellness

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Weight Loss History/Intake Form

Physican Approval Form

Exercise Physiologist's Training Contracts



Nutrition
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Nutritional intake form

Three Day Food Record




Traditional Chinese Medicine

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TCM History Form


Behavioral Health

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Initial Intake form

Consent To Treat/office Financial Forms




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Community Content

Mon 7am to 7pm
Tue 7am to 7pm
Wed 7am to 7pm
Thu 7am to 7pm
Fri 7am to 7pm
Sat 8am to 3pm
Sun Closed

Call Us:
847-593-3330
Request
Appt.

Contact

First Health Associates
2010 S. Arlington Heights Rd. #42
Arlington Heights, IL 60005
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  • Phone: 847-593-3330
  • Fax: 847-593-3346
  • Email Us
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