Scheduling Examinations and Patient Paperwork

Our Practice has MOVED to 125 S. Bloomingdale Rd Suite #11 in Bloomingdale, effective 01/16/2012.  Please call if you need assistance finding our new location.

For new patients scheduling an initial examination…

  1. Call 224-653-8094 to schedule your new patient examination. We do our best to see you within 24 hrs of your call. Click here for directions to our office.
  2. Print out the New Patient Intake Form and please fill it out before your visit.  (Please note:  You will need a pdf reader to be able to access the forms on this page.  If you are not able to access these forms from your computer, you may fill them out when you come to our office.)
  3. Bring any x-rays or MRIs that pertain to your current problem and new patient paperwork & questionnaires to your first visit and allow about an hour for the doctor to complete your examination.
  4. Please also bring the following information for insurance processing:
    • Major Medical Insurance: Bring your current insurance card.
    • Personal Injury/Motor Vehicle Accident: Bring car insurance information for both parties, claim # information and police report if available.  You also need to fill out this Motor Vehicle Accident form.
    • Workman’s Compensation: Notify your employer and bring incident/claim # along with insurance company contact information.

For existing patients scheduling an examination for a new injury…

  1. Call 224-653-8094 to schedule an existing patient examination for a new injury.
  2. Print out the New Injury Update Form and please fill it out before your visit.  (Please note:  You will need a pdf reader to be able to access the forms on this page.  If you are not able to access these forms from your computer, you may fill them out when you come to our office.)
  3. Please bring any new or updated insurance information if there has been changes since your last visit with us.

 

Patient HIPAA Notice