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Therapy Request

Phone (224) 256-2607

Text (815) 517-2316

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Therapy Request

To request an appointment, please fill out the information below.

Client's First Name

Client's Last Name

Best Contact Number

Email

City/Town

Client's Birthday

Contact Form

NOT USED FOR
REQUESTING/CANCELING/RESCHEDULING
APPOINTMENTS

CRYSTAL LAKE, IL

1095 Pingree Rd. Suite 204

Crystal Lake, IL 60014

Main: (224) 256-2607

Fax: (224) 256-2615

Appointment Hours:

Mon - Fri: 9am - 8pm

Saturday: 10am - 5pm

Sunday: 10am - 3pm

CRYSTAL LAKE, IL

820 E. Terra Cotta Ave. Suite 116

Crystal Lake, IL 60014

Main: (224) 256-2607

Fax: (224) 256-2615

Appointment Hours:

Mon - Fri: 9am - 8pm

Saturday: 10am - 5pm

Sunday: 10am - 3pm

Thanks for submitting! This form is not used for rescheduling or canceling appointments. If you would like to make an appointment, please use this link https://www.bcs4you.com/request-appointment

SOUTH BARRINGTON, IL

33 W. Higgins Rd. Suite 955

South Barrington, IL 60010

Main: (224) 256-2607

Fax: (224) 256-2615

Appointment Hours:

Mon - Fri: 9am - 8pm

Saturday: 10am - 5pm

Sunday: 10am - 3pm

NASHVILLE, TN

1994 Gallatin Pike N. Suite 202 Madison, TN 37115

Main: (224) 256-2607

Fax: (224) 256-2615

Appointment Hours:

Mon - Fri: 9am - 8pm

Saturday: 10am - 5pm

Sunday: 10am - 3pm

Privacy Policy HIPAA Compliant Statement

BILLING INQUIRIES

Main: (815) 670-9059

Mon - Fri: 9am - 4pm

Sat & Sun: Closed

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