Phone: (847) 920-4NIH (4644) | Email

Patient Forms

Thank you for choosing NIH. We appreciate your trust in us and look forward to working together to help you reach your goals.

For your convenience, you may choose to review our policies and complete your paperwork at home. Click on the 5 New Patient Information Forms listed below to print the PDF forms. Once printed, please fill out the forms at home and bring them with you to your first appointment. Since your therapist may want some additional information, please come to your first appointment 10 minutes early.

If you are seeing one of our therapists for therapy, an evaluation, or testing, several forms must be completed before we can begin to discuss your concerns. Having these forms filled out in advance allows us to use our time together most productively.

If you are meeting with a clinician for visits specifically related to a surgical procedure, please arrive at the office 15 minutes early to complete a few brief forms.

If you choose not to print and complete these forms in advance of your appointment date, they will be available for you at the time of your appointment.

Your Adobe print button will enable you to print all of the forms. If you have trouble viewing the forms, click here to download a free copy of Adobe Reader.

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New Clients

Patient Handouts

Breathing Exercise Instructions
Coping with Grief
Glycemic Index & Glycemic Load Information
Headache Elimination Diet Information
Healing Through Forgiveness
Improving and Maintaining a Healthy Sleep-Wake Cycle
Managing Stress
Meditation for Health and Happiness
NIH Food Diary
NIH Headache Diary
NIH Sleep Diary
Non-Drug Approaches for Managing Osteoarthritis
Non-Drug Approaches to Help Move from Depression to Feeling Happier With More Energy
Non-Drug Ways to Promote Health by Lowering Blood Pressure
Non-Drug Ways to Promote Health by Lowering Cholesterol
Omega-3 Fats
Pain Diary
The Anti-Inflammatory Diet Information
Thought Record for Anxiety
Using Journaling to Aid Health


Diaphragmatic Breathing


Autogenic Relaxation


Progressive Muscle Relaxation