On this page you will find links to our intake form as well as our financial policy / patient privacy statement. Please download,print, and fill out both forms accordingly. Once completed you may fax them to us along with a copy of your insurance card at (847) 513-6998. We appreciate having these forms faxed over prior to the visit as it helps to expedite your initial consultation. If unable to fax them, please bring them with at your scheduled appointment time, along with your insurance card.