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Practice Name

Optimal Health & Wellness Center, Ltd.

Social Media
Primary Location
800 N. Roosevelt Road, Building D, Suite 104
Glen Ellyn, IL 60137
Phone: 630-858-9900
Fax: 630-858-9905

Office Hours

Day
Monday9:00–12:302:30–6:00
TuesdayClosed
Wednesday9:00–12:302:30–6:00
Thursday9:00–12:302:30–6:00
FridayClosed
SaturdayClosed
SundayClosed
Main Content

Optimal Health & Wellness Center, Ltd. offers our patient form(s) online so you can complete it 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.


Chiropractic Patients:

New Patient Forms (Adults)
Download and Print Forms

New Patient Forms (Children)
Download and Print Forms

Child Nutrition Form
Download and Print Form 


Ideal Protein Patients

Ideal Protein Health Profile Form
Download & Print Form


Purification/Detox Forms:

New Patient Forms (Adults)
Download and Print Forms

Toxicity & Purification Forms (Goalsetting)
Download & Print Form

Toxicity & Purification Forms (Mid-point Cleanse)
Download & Print Form

Toxicity & Purification Forms (Toxicity Questionnaire)
Download & Print Form


Nutritional Consult Forms:

Adult Intake Form
Download and Print Forms

Food Diary Form
Download and Print Forms

Metabolic Assessment Form
Download and Print Forms

Nutritional Consultation Form
Download and Print Forms


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form


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Download the Free AdobeReader®

Exclusive Offer

Special offer for new and current patients:
Enter your name and email for FREE INSTANT ACCESS to a report that will CHANGE YOUR LIFE TODAY!
Sign up using this form or call us at 630-858-9900 to take advantage of this exclusive offer.

Name: *
Email: *
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Featured Services

Services We strive to provide complete care for our patients. Learn more about all the services we provide. Make An Appointment Optimal Health & Wellness Center, Ltd. will do our best to accommodate your busy schedule. Schedule an appointment and TAKE THAT FIRST STEP TO CHANGING YOUR LIFE, TODAY! Download Online Forms Optimal Health & Wellness Center, Ltd. offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

Testimonial

Thank you so much for helping my son we really learned a lot about health and how sophisticated the human body really is.

Stephanie

Office Hours

Day
Monday9:00–12:302:30–6:00
TuesdayClosed
Wednesday9:00–12:302:30–6:00
Thursday9:00–12:302:30–6:00
FridayClosed
SaturdayClosed
SundayClosed
Day
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9:00–12:30 Closed 9:00–12:30 9:00–12:30 Closed Closed Closed
2:30–6:00 2:30–6:00 2:30–6:00

Contact

  • 800 N. Roosevelt Road, Building D, Suite 104 Glen Ellyn, IL 60137
  • 630-858-9900
  • Get Directions
 

As of January 1, 2015: Google Maps has corrected the location marker for our office and the "Directions" information.  You may use Google Maps to find the directions to our office. It is still recommended to use the map below, and click on it to view it larger or to print it.

Newsletter

Newsletter Sign Up










Community Content
Member Wellness