Online Forms

New Day Wellness Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Email back your printed and completed form(s) or bring them with you to your appointment.

The Following Forms Are Required

Please complete, sign and submit the following forms to us at least 48 business hours before your first appointment. This will reduce waiting time at your appointment and allow the doctor to evaluate your medical history, spend more time during the appointment getting to the root of your symptoms, and get you on the road to recovery faster!

1.) Contact Form

2.) HIPAA Acknowledgement

3.) Financial Policy

4.) Cancellation Policy

 (The above fillable pdfs can be filled out and saved directly on your computer and emailed to [email protected], or printed and then scanned and emailed, or mailed by post, or personally delivered to our office with the form below.)
5.) Initial Intake (Medical History) Page 1 and Pages 2-8
(Please print and complete BOTH page 1, and pages 2-8 at the links above. The Initial Intake forms cannot be filled directly on your computer, but must be downloaded then printed to complete by hand. Once completed, either scan and email the form to [email protected], or return this in person or via post to New Day Wellness Center 48 business hours prior to your first appointment)

6.) Privacy Policy  (read only)


Thank you for your time and cooperation in helping us serve you better!

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Office Hours - Call for Availability

Appointments Taken For:


4:00 pm-8:00 pm


1:00 pm-8:00 pm


11:00 am-5:00 pm


12:00 pm-4:00 pm


9:00 am-3:00 pm






Reviews By Our Satisfied Patients

    For several years, I have suffered from migraines. The pain made it difficult to function, light intensified the pain and almost any activity was unbearable. I've tried many solutions: I saw several different chiropractors and even tried herbal remedies and acupuncture. From the first appointment with Dr. Dybala, she worked with me to figure out what my migraine triggers are. Dr. Dybala really takes the time to listen and work through any issues...

    Tayce S., Schaumburg

    I highly recommend Dr. Dybala as your naturopathic doctor. She is very caring and thorough when it comes to your complete health. I was always tired and had shortness of breath. Dr. Dybala had me get some tests related to my symptoms. After those tests, I found out I had a widow maker and needed heart bypass surgery. She has also helped me figure out how to get healthier. Dr. Dybala looks at not only symptoms but potential causes of issues to figure out a good plan...

    Corey S., Wheaton

    After we moved last spring, we were looking for a natural primary care physician for our two young boys. That's when we found Dr. Dybala! What a blessing! She takes time with us and really listens to help treat our family from the inside out. Whenever we've needed to see her right away, she has always made time. Her knowledge of working with and treating the whole person and getting to the cause of ailments is impressive. Dr. Dybala is a doctor for the whole family.

    Dawn M., Glen Ellyn

    What I appreciate most about Dr. Dybala is that she works diligently to get to the cause of my issues and then offers me several options for treatment. She will share insight as to how involved each treatment option may be or how long to expect for healing, but she lets me decide which one I feel is best for my body. I'm thrilled to be in the care of someone who treats the whole body and not just one particular symptom. She is empathetic, extremely dedicated to healing her patients...

    Jill F., Wheaton