The Moline Chiropractor to see - Chiropractor Moline

Your Health History

We offer our paperwork on line so you can complete it in the convenience of your own home. Here are the essential forms we use and why we need them.

New Patient Form

This let’s us know what’s happened, but perhaps more important, where do you want to take your health?
Download & Print Form

Personal Injury

If your health issue is the result of a non-work related accident, we need some additional information.
Download & Print Form

Worker’s Compensation

If your health issue is the effect of an injury at work, this information will help us help you.
Download & Print Form

Free AdobeReader®

Each form is a PDF document file. If you do not already have AdobeReader® installed on your computer, click the Adobe® image to download for free.



Dr. Wayne Davis, 4300 12th Avenue, Moline, IL | (309) 764-4753
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Dr. Davis Asks some important questions of interest to Moline residents - Chiropractor Moline Dr. Davis Asks...

Are chiropractors just concerned with the spine?
Our interest in the spine is because it covers the major communications conduit between your brain and your body. As a Moline chiropractor my job is to locate areas (usually along the spine) that interfere with proper nerve communications to and from your brain. Chiropractic adjustments help restore nervous system integrity. In this way, chiropractic care can affect the function of your entire body.
Why do so many drugs require a prescription?
Because they can be dangerous? I chose a chiropractic career specifically because it avoids artificial means of pain relief. Our Moline chiropractic practice attracts health-conscious families that prefer a safe and natural solution. Ready to get started? Call our office today.