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Health on Earth Wellness Center LLC offers our patient forms online so they can be completed in the convenience of your own home or office, before you even arrive to our chiropractic 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 Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form

Download the Free AdobeReader®

Exclusive Offer

New Patients receive a Complimentary Wellness Exam.

THIS ---->https://healthonearthlive.chiromatrixbase.com/online-forms.html

Office Hours

Day Morning Afternoon
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
9-11am Closed 9-11am 9-11am 9-11am 10am-1pm Closed
4-6:30pm 4-6:30pm 4-6:30pm 4-6:30pm 4-6:30pm Only Closed


Dr Vaught and the staff are fantastic. I love to have massages they are awesome here. Always treat yourself and health to the best because you only have one body and life to live. Thank you health on earth for your fine job here!!!!

Crestwood, IL

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