Please welcome Dr. Jason Lee Smith!

We've written a letter to you, our community, in regards to Dr. Smith joining our team: Click here to read the letter!

158 Bartlett Plaza, Bartlett, IL 60103
(630) 830-2121
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  • Home
  • About
  • Auto Injury
    • Chiropractic and Auto Injuries
    • Common Symptoms
      • Back Pain
      • Chronic Pain
      • Dizziness
      • Headache
      • Neck Pain
      • Radicular Pain
      • Shoulder Pain
      • Thoracic Outlet
      • TMJ Pain
    • Early Treatment
    • Preventing Injury
  • How We Help
    • About Chiropractic
      • Chiropractic for Kids
      • Chiropractic for Seniors
      • Pregnancy and Chiropractic
      • Sports and Chiropractic
    • Auto Injuries
    • Exercise
    • Ideal Protein
    • Nutrition
    • Pain Relief
      • Back Pain
      • Dizziness and Vertigo
      • Fibromyalgia
      • Headaches
      • Hip and Joint Pain
      • Knee and Leg Pain
      • Neck Pain
      • Sciatica
      • Shoulder Pain
    • Work Injuries
  • Locations
    • Bartlett Pain and Wellness Center
    • St. Charles Pain & Wellness Center
  • Contact
  • Patient Forms

Patient Paperwork

Please download and fill out the appropriate paperwork forms below before your visit.

New Patient Paperwork Form

Medical Release Form

Payments and Statements Form

Cancellation Policy Form

Consent to Treat Form

Consent to Care Form

Privacy Practice Form