New Patient Paperwork

We offer our patient form online so it can be completed in the convenience of your own home or office.

How to Complete Your Paperwork

Getting your paperwork ready before your appointment is simple.

  • Download the New Patient Registration Packet.
  • All forms are provided in PDF format.
  • If you do not already have a PDF reader installed on your computer, download Adobe Acrobat Reader® to open the file.
  • Print the packet and complete all requested information.
  • Bring the completed registration packet with you to your appointment.

Preparing for Your First Appointment

To help your visit go as smoothly as possible, please bring:

  • Your completed New Patient Paperwork
  • A valid photo ID
  • Your insurance card (if applicable)
  • Any recent X-rays, MRI scans, CT scans, or imaging reports related to your condition, if available
  • A current list of medications and supplements
  • Comfortable clothing if a physical examination is expected

Your first appointment typically lasts about one hour and may include a consultation, physical examination, functional assessment, and on-site X-rays.

SuperiorMED
328 W. Washington Street
East Peoria, IL 61611

Mon-Thur: 9:00 am - 5:30 pm
Fri-Sun: Closed

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