Schedule Appointment - Galesburg - Pain Relief Chiropractic

GALESBURG Office Location

Whether you are new to us
or an existing patient,
please use our convenient on-line appointment request form!
Click Here For Massage Therapy Scheduling!

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

Your First Name (required)

Your Last Name (required)

What Category of Patient Are You? (required)

New PatientExisting Patient

Your Email (required)

Your Phone Number (required)

Please choose a preferred date

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

General ChiropracticAuto InjuryWorkers Comp

Briefly describe the nature of your appointment request
*Please do not include any Protected Health Information.

Once you click send, we will contact you as soon as
possible to finalize the date and time of your appointment,

•• Please Note ••
Dr. Wilson is at the Galesburg clinic
on Monday's, Wednesday's, and Friday's only
He is at the Bettendorf office on Tuesdays, Thursdays and Saturday mornings

Ronda and Elizabeth are generally
available most all weekdays for massage.
Click HERE for specific massage scheduler

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 (Required for all patients and massage clients)

General Patient History Form (Chiropractic patients)