Schedule Appointment

To schedule an appointment with one of the Circle of Wellness staff members, you can either email us or give us a call.

If you are a new patient, Click here to download the new patient intake form. Please complete the form and bring it to your first appointment.

Oncology patients – Please click to dowload the Oncology Intake Form as well as the Physician Release Form

Telephone: (779) 423-1700
FAX: (866) 596-1027
3626 E. State St. Rockford, IL 61108

Monday – Friday: 8:30 AM to 8 PM
Saturdays: 10 AM to 5 PM

Schedule Appointment

First Name

Last Name




Preferred Date of Appointment

Preferred Appointment Time

How do you want us to confirm your appointment? By PhoneBy Email

Are you a new patient? YesNo If You are a new Patient, Please download the patient information form and bring the completed form with you to your appointment.

How did you hear about Circle of Wellness?

Additional Comments

Preferred appointment requests are not guaranteed. Staff will contact you confirm your appointment or suggest an alternate time.