Office Forms

After you have scheduled an appointment at our office, please print out the forms below, complete the information required and bring them with you to your first visit. This will allow our staff to process your information more quickly and lessen your waiting time. Thank you.

Registration Form

Adult History Form

Newborn to Adolescent History Form

Influenza Vaccine Consent Form 

If you need our office to release your records, please fill out the following form and mail it or fax it to our office.

Records Release

The Pre-participation Physical Examination form (from the Illinois High School Association's website (ihsa.org)) 

School Physicals Form  - (Certificate of Child Health Examination from the State of Illinois Department of Human Services).