We would like to take this opportunity to welcome you to Chicagoland Complete Healthcare and thank you for choosing us to provide you with your medical care.

  1. Please download the new patient paperwork, and bring the completed and signed forms to your appointment.
  2. If you are unable to keep your appointment, please notify us within 24 hours of your appointment time so we can help to reschedule you to a more convenient time and to avoid a $50 cancellation fee.

NEW PATIENT REGISTRATION FORM

CREDIT CARD POLICY & AUTHORIZATION FORM

PATIENT PRIVACY & FINANCIAL POLICIES

INCOMING MEDICAL RECORDS

Please also bring:

  • Drivers License or State ID
  • Insurance Cards & Copay (Cash, Check, Credit Card)
  • Medications or Medication List
  • Preferred email address and phone number
  • Pharmacy Information

Other Info:

  • Please arrive 15 minutes before your first appointment for registration
  • Parking may be validated on the first floor of building at security
  • Please notify us at least 24 hours in advance to cancel or reschedule office appointments to avoid $50 no-show/last minute cancellation fee.