For your convenience:

You can download and complete the Intake Form on our website and bring it with you to your first visit:

Click here to get the form.

Contact Me

Jacqueline N. O'Neill, MSTOM, L.Ac.
Chicago office: 3723-25 N. Southport Ave., Chicago, IL 60613
Telephone: (773) 576-3925
E-mail: jackie@collaborativecarechicago.com

Take a moment to contact me and I will be in touch shortly. Your comments are appreciated. If you would also like to download a Collaborative Care Intake Form, please click on either the link in the right column »

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Daytime Phone   Evening Phone   E-mail

Area of Interest:

Fertility   General Ailment   Acupuncture   Moxa   Cupping   Nutrition
  Women's Health   Dermatology   Menstrual Irregularities/PMS

Comments or Questions:


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