Forms/Paperwork
All new patients need to complete an online patient portal profile in order to complete intake forms, keep their billing information up to date, and receive statements regarding services at PCPA. After you speak to one of our intake coordinators, you will receive an email from [email protected] which will have your username. Please click on the link to start the set up of your patient portal account. You will receive a second email from [email protected] within 24-48 hours which will direct you to our intake forms. Please call us at 847-686-0090 if you encounter difficulties during this process.
Our patient portal can be accessed by clicking on the following link: https://www.valant.io/Portal/PCPA.
Parents will need to complete PCPA's intake forms for patients under the age of 18. If parents of patients under the age of 18 are divorced AND share custody, both parents should sign the intake forms.
Prior to your first appointment, please kindly review PCPA's Privacy forms by following the link below:
