New Patients:

The following forms are used by our staff to begin treatment for new patients. Forms can be received through e-mail (Please save the file first and edit), printed and faxed (847-686-0090), or printed and delivered in person upon your next visit. 

• Adult Patient Intake Form
• Child and Adolescent Patient Intake Form
• Child Speech Therapy Intake Form
• Release of Confidential Information
• HIPAA Notice Form - Protection of Privacy
• Insurance FAQ's