Online Patient Forms


For your convenience, you may pre-register with us by printing off and filling out our patient information, health history and patient consent forms and mailing them in to our office prior to your visit.

 Simply click the New Patient Registration form and Health History Form and the download will begin. Then print the form, fill it out and bring to your appointment. This will save you time when you come in for your first visit with us.




4241 HWY 14 West

PO Box 155

Christopher IL 62822

All Locations


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FTCA Deemed Facility

This health center receives HRSA funding and has Federal Public Health Service (PHS) deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.