BETTENDORF Office Location

Whether you are a new or existing patient,
please use our convenient on-line appointment request form!

After you complete the form below, press SEND
and we will contact you as soon as possible to confirm your scheduled appointment.

    What Category of Patient Are You? (required)

    What Type of Case is This? Check All that apply.(required)

    •• Please Note ••
    Dr. Wilson is at the Bettendorf office
    on Tuesday, Thursday and Saturday Morning ONLY
    He is at the Galesburg office on Monday, Wednesday & Friday

    New Patients! To save time at your first visit,
    Download and Complete the Patient Information and History Forms.
    This is Not required, just a convenience. You can do this when you come in.

    Patient Information Intake Form

    Patient History Form

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