Circle of Wellness Rockford IL

Body Scan Tool Questionnaire

Consultation Request Form

body-scan-poster Head Face Neck Arms Hands Breast Sides / Flanks Abdomen Back Genitals Buttocks Thighs Legs Knees Feet

4 Easy Steps to a Healthy You!

  1. Fill in your contact information.
  2. Click on the body area to view symptoms.
  3. Select your symptoms.
  4. Submit and receive your personalized treatment recommendations.
Completing the following form will help staff recommend what services at Circle of Wellness could be most beneficial to you. All submissions are confidential and will only be shared with Circle of Wellness staff.

Body Scan Tool

To request a consultation,
complete the Body Scan Tool