HealthSource Supervised Weight Loss

Set A Free Consultation Appointment

Congratulations on making the decision to start losing weight NOW!

Just fill in the form below to set an appointment to come in for a FREE Consultation with your local HS HealthSource® Doctor (up to a $295 Value!) (Fields denoted with an asterisk(*) are required)
Your Name *
Your Address *
Your City *
Your State *
Your Zip Code *
Your Daytime Phone (including area code) *
Your Email *
Your Date of Birth * (must be 18 to come in for consultation)
How Did You Hear About HS HealthSource®? *
If you heard about us from an ad, please tell us the name of the newspaper or describe the ad:

Please choose the location you'd like to come to for your consultation *
Day and Time Window That Works Best for You *
NOTE: Once you choose which time is more convenient, you'll receive a phone call from our appointment desk so we can let you know the exact times available during the window you chose and get you on your way to losing the weight you want. There's no cost or obligation for this consultation.

HealthSource Chiropractic Inc. ©2008
4365 Liberty Ave. Vermilion, OH 44089
Phone: 440-967-5458 or 1-800-694-4234
Fax: 440-967-8715