It's Time to Make Yourself a Priority ...
Give Yourself the Gift of Good Health, Naturally.

Dr. Annette Schippel also offer phone consultations to patients who do not live in our area.  She uses a
complete case history, based on the paperwork you will be required to fill out.  Your phone consultation will
include an interview with you and recommendation of the appropriate tests that will be done in the comfort of
your own home.  Tests may include hair analysis for the mineral levels, giving us insight into the function of
your thyroid and adrenal glands along with blood sugar handling and protein metabolism; and saliva testing
for estrogens, progesterone, testosterone, DHEA, pituitary hormones and/or cortisol.  She will go over the test
results over the phone and make recommendations.

Click on each of the links below to fill out the required paperwork.  Please fax your completed paperwork to
(217) 245-2524.

Upon receiving your paperwork Jessica will call you to schedule your initial phone consultation.  Credit Card
information will be collected from you at this time.  We gladly accept Master card, Visa, and Discover.  

If you would like further pricing information for this service, please call or email Jessica.
(217) 245-2524
drannette@drjlang.com

Dr. Annette does phone consultations Monday through Friday.

Here are the required forms:  You will choose only the New Patient Info. Form and History Questionnaire that
applies to you.  However everyone will do the Symptom Survey.  Thank you ... And we look forward to working
with you!

New Nutrition Patient Info.
Youth New Nutrition Patient Info.
Symptom Survey
Female History Questionnaire
Male History Questionnaire
Youth Health History Questionnaire
Schippel Chiropractic
Dr Karl P. Schippel & Dr. Annette Kutz Schippel
1429 S. Main Street
Jacksonville, IL 62650
Ph: (217) 245-9797        Fax: (217) 245-2524
schippelchiropractic@yahoo.com