Intake Forms

New Patient Intake

Medical Wellness

Better Days Wellness Clinic is dedicated to providing the best care and solutions to your medical wellness goals. In order to provide the highest level of service and care, please fill in the following information. Accuracy is very important, please provide the most up to date information. If you have any questions or concerns regarding the required information, please call or email so we may provide you with the support you need. 

Phone: (224) 507-5195 

Email:  info@betterdayswc.com 

Complete the appropriate form for your service.

 An email confirmation will be sent to the email you provide

Weight Loss

Teeth Whitening

Chemical Peel

Wellness Injections

Body Contouring

Lipodissolve Intake