Online Forms

We offer our paperwork on line so you can complete it in the convenience of your own home. 


Health History

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

 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.


When you’re ready to take action, ring us at Light House Family Chiropractic to arrange your first visit: (630) 443-4411.




Light House Family Chiropractic
525 Tyler Rd, Suite R1, St. Charles, IL | (630) 443-4411

Dr. Sheryar Asks some important questions of interest to St. Charles residents - Chiropractor St. Charles Dr. Sheryar Asks...

Can chiropractic cure a child's ear infections?
Chiropractic isn't a cure for anything. Nor is it a treatment for ear infections. However, many children who suffer with ear infections also suffer from spinal problems in their neck, compromising nerves to the ear, depressing the immune system and preventing proper drainage. Can chiropractic help? Find out!
Can a chiropractor heal?
There's never been a case in which a doctor (chiropractor or otherwise) has formed scar tissue, mended a broken bone or cured a headache. Only you can do that. Turns out you're the doctor! All I do is help remove interferences to your body's healing ability. Ready to get started? Call our office today.