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Call: (773) 525-1150

Patient Forms and Online Payment

 

Patient Forms 

Dear Patient,  the link below contains our patient forms that will need to be filled out before you arrive at our office. They include a medical history form, COVID-19 questionnaire, HIPPA, patient consents, office policies and an online payment portal.  Filling them out will allow us to attend to your needs more quickly than completing them on your arrival.  Thank you and please call our office if you have any questions at all at 773-525-1150 or to schedule an appointment

Online Payment Registration

The link below provides you with the ability to register for online payment with our office. Please click on the link to set this up before your visit. Filling this out will allow us to attend to your needs more quickly then collecting payment at the time of your appointment. Thank you and please call our office if you have any questions at all at 773-525-1150 or to schedule an appointment.

Online Payments