CONDITIONS
TREATED
TREATED
• HEAD & NECK
• BACK PAIN
• WRIST/HAND PAIN
• INFERTILITY
• KNEE & HIP PAIN
• INSOMNIA
• HEADACHES
• MIGRAINES
• CHOLESTEROL
• BLOOD PRESSURE
• MUSCLE SPASMS
• LEG CRAMPS
• CONSTIPATION
• IRRITABLE
BOWEL
SYNDROME
• FATIGUE
• NERVE
PAIN
• PMS
• INJURIES
• DIABETES
• INFECTIONS
• ANXIETY
• DEPRESSION
• AUTO ACCIDENT
• AND MORE
• BACK PAIN
• WRIST/HAND PAIN
• INFERTILITY
• KNEE & HIP PAIN
• INSOMNIA
• HEADACHES
• MIGRAINES
• CHOLESTEROL
• BLOOD PRESSURE
• MUSCLE SPASMS
• LEG CRAMPS
• CONSTIPATION
• IRRITABLE
BOWEL
SYNDROME
• FATIGUE
• NERVE
PAIN
• PMS
• INJURIES
• DIABETES
• INFECTIONS
• ANXIETY
• DEPRESSION
• AUTO ACCIDENT
• AND MORE
Patient Forms
| medical alternatives corp ~ 238 e adams st., suite 3 ~ nashville, illinois 62263 ~ 618.327.8717 |
New Patients
Auto Accidents
Work Injury
Misc Forms
We are pleased to offer you our office forms online to speed up the process while at our to
forms@advancedehealth.com. If you are a NEW PATIENT - then please fill out all the forms
under New Patient as well as any forms that apply to your condition or type of injury. If you
are a MEDICARE patient you MUST fill sign the Medicare ABN form. If you are under 18, we
will need the Consent to Treat a Minor/Child filled out. If you would like us to get a copy of
past medical care, diagnostic films, or lab work, please fill out the Medical Records Request
Form and either send it to your health care provider, or request us to send it to them.
If you have any questions as to which forms to fill out - please call our office at 618.327.8717
forms@advancedehealth.com. If you are a NEW PATIENT - then please fill out all the forms
under New Patient as well as any forms that apply to your condition or type of injury. If you
are a MEDICARE patient you MUST fill sign the Medicare ABN form. If you are under 18, we
will need the Consent to Treat a Minor/Child filled out. If you would like us to get a copy of
past medical care, diagnostic films, or lab work, please fill out the Medical Records Request
Form and either send it to your health care provider, or request us to send it to them.
If you have any questions as to which forms to fill out - please call our office at 618.327.8717