New Patient Forms
Welcome! To make your first visit faster and easier, you can download and complete our new patient forms at home.
If you don’t have access to a printer, no worries — you can fill them out when you arrive at our office.
If You Don't Have A Printer
No printer? No problem.
We have forms available in the office, and we’ll make sure you’re comfortable and have plenty of time to complete them before your visit.
What to Bring to Your First Visit
Your completed forms (if printed at home)
A photo ID and insurance card (if using insurance)
- 1-2 pair of old shoes
Comfortable clothing for evaluation
Any recent imaging or reports (optional but helpful)
What to Expect
Your first visit includes:
Focused exam
Clear report of findings
First adjustment (if safe to do so — most are adjusted that day)
3 home actions to help your healing continue between visits
💰 Transparent Fees:
$97 first visit (includes exam, report, adjustment, and home plan)
$63 follow-ups — or insurance billed at reasonable and customary rates.
Ready to Get Relief?
Most Libertyville patients experience noticeable relief within 1–3 visits.
Dr. Steve Segal provides honest, effective, and affordable care — visit by visit.
Call/Text: 847-778-3627