Online Forms


Tri Modern Health offers our patient form(s) online so they can be completed in the convenience of your own home or office.

We Look Forward To Seeing You!


move with balance your local chiropractor





New Patient Paperwork - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Please download the forms shown below: 



Chiropractic New Patients Forms 

NEW PATIENT PAPERWORK - ADULT

Prenatal/Pregnancy New Patient Paperwork

Pediatric/Kids New Patient Paperwork


Forms may be filled out on your desktop/computer or laptop. 

You do not need a printer - Follow these steps 

Download  and save form to your computer before beginning

Start filling out (Printer is not needed) 

Save file again 

You may attach and email the form to [email protected] 24 hours before your first visit.

Our email is: [email protected]

Note: Additional Paperwork may be required at the time of your visit. 

Note: If you have any issues sending us these forms prior to your appointment time. Please call our office at (847) 884-8488 as we may need to change your appointment time. 


Acupuncture Patients - New Patient Forms

Acupuncture New Patients - Fill this Form Out

Note: Our New Patient Forms for Acupuncture Patients currently requires a printer if you are completing forms at home. 

You may attach and email the form to [email protected] 48 hours before your first visit.

Our email is: [email protected]





FORMAS PARA PACIENTES NUEVOS EN ESPANOL: 

Descargue la forma que se muestran a continuación: 

 FORMAS PARA PACIENTES NUEVOS - ESPANOL


Please read carefully 

  • If you are experiencing are experiencing any cold or flu like symptoms or feeling ill, please do not come in for your appointment. For more information please visit our Home Page. 
  • Please note our current office hours below. 

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Send us your printed and completed form(s) or bring it with you to your appointment. You may also drop your paperwork off at the office prior to your appointment time/day. 


 


Our office is currently open  

We are Accepting New Patients

We Look Forward To Seeing You!

Please call the office to schedule your appointment for further details and instructions. 

At this time we are not able to accept walk in appointments. 

Monday: 9:00 am-12:00 pm,  3:00 pm-6:00 pm  

Tuesday: 3:00 pm-5:00 pm 

Wednesday:  CLOSED

Thursday:  9:00 am-12:00 pm, 3:00 pm-6:00 pm

Friday: CLOSED

Saturday: 8:30 am-11:00 am


TO LEARN MORE ABOUT OUR RESPONSE TO COVID-19 CLICK HERE


Our Location:

Dr. Hector Martinez, DC

Tri Modern Health

(847) 884-8488

1000 Grand Canyon Parkway Hoffman Estates IL 60169


Cancellation Policy


If you are unable to keep an appointment, we ask that you kindly provide us with at least 24 hours notice. We ask for this advance notice so that we can offer this appointment to another patient. A fee may be charged if a patient does not show up for an appointment without sufficient notice. A fee may also be charged if a patient does not show up up for a scheduled appointment without notice (notice must occur at least 24 hours prior and notice must be a phone call). 




Hours of Operation

Our Regular Schedule (Please call for new patient hours) Hours subject to change or may vary without notice.

Monday

9:00 am - 12:00 pm

3:00 pm - 6:00 pm

Tuesday

3:00 pm-5:00 pm

Wednesday

CLOSED

Thursday

9:00 am - 12:00 pm

3:00 pm - 6:00 pm

Friday

CLOSED

Saturday

8:30 am - 11:00 am

Closed

Sunday

Closed

Monday
9:00 am - 12:00 pm 3:00 pm - 6:00 pm
Tuesday
3:00 pm-5:00 pm
Wednesday
CLOSED
Thursday
9:00 am - 12:00 pm 3:00 pm - 6:00 pm
Friday
CLOSED
Saturday
8:30 am - 11:00 am Closed
Sunday
Closed

Our Location

REQUEST AN APPOINTMENT TIME

Use the form below to Request an Appointment - Actual Appointment Times May Vary