Paperwork & Payment Options

Patient Paperwork

We offer our paperwork online so you can complete it in the privacy and convenience of your own home.

Please be sure to bring them with you to your first appointment at our back pain treatment center in Edwardsville, or you may fax them to us ahead of time.

Here are the essential forms we use and why we need them: 

Patient Intake Form

This form lets us know both the reason for your visit and, perhaps more importantly, where you want to take your health from here.

Download Form

Payment Options

At CORE Physical Medicine, we work with all insurance plans. Please remember to bring your insurance card with you for your first New Patient Consultation. If your insurance provider changes during the course of your care, please let us know, as we will make changes accordingly.

We accept a variety of payment methods including:

  • Care Credit
  • Cash
  • Personal Checks
  • Credit or Debit Cards (Visa, MasterCard, or Discover)


Patient Testimonials

John Watts says...

After three weeks of therapy, I felt like a new person. The best thing about CORE? They weren't pushy.

New Patient Consultation

Receive a free one-on-one comprehensive orthopedic and neurological evaluation with a doctor.
CORE Physical Medicine Wellness Center

Our Facilities

Visit our back pain relief centers in Edwardsville and Millstadt to learn about the benefits of chiropractic care and discover longterm back pain relief.
CORE Physical Medicine Wellness Center

Copyright © 2017 - CORE Physical Med - All Rights Reserved.

We offer a full range of pain relief services including back pain, neck pain, and rehabilitation services. We don’t like to think of ourselves as chiropractors - we prefer pain relief specialists. Our service area includes Madison County, the Metro East area, and southwestern St. Clair County.

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CORE Physical Medicine - Edwardsville    CORE Physical Medicine - Millstadt
#4 157 Center Edwardsville, IL 62025    15 North Jefferson St Millstadt, IL 62260
Call 618.692.5555 or Contact Us    Call 618.476.6677 or Contact Us