Intake Forms

Please print forms then fill out legibly in black ink
​If you are unable to download the pdf  files, please download Adobe Reader

Location & Hours

​ISLAND CHIROPRACTIC 
​Dr. Charles Wakeland
1605 W. Wilson St., Ste. 116
Batavia, IL  60510
(630) 879-0799
www.DrWakeland.com

​​MONDAY - SATURDAY
By Appointment
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