New Patient Forms
New Patient
Forms

Momentum Health Center offers our patient forms online so you can complete them in the convenience of your own home or office.

These forms let us know the history and current state of your health.
You should download them and print them out for your first visit.

New Patient Form

Acupuncture Form

Most major health providers accepted

Contact us with your questions and comments

Momentum Health Center
45 S. Dunton Ave.
Arlington Heights, IL 60005
map >

(847) 637-5242
mhcarlingtonheights@gmail.com

[contact-form-7 id=”3606″]
Menu
Call Now Button