The following secure forms are available for your convenience.
Please fill out the Online Form (green bar) and any other forms that are appropriate. Don’t forget to click the Submit button when done!
This will give us a head start on preparing for your appointment! If you have any questions, just give us a call at 309-454-1010
- Online Patient History Form **All Patients** [URL]
- Expanded History Form (Preschool Ages 3-5) [PDF]
- Expanded History Form (School Age K-12) [PDF]
- Records Release Form [PDF]
- Link to Online Patient Portal [URL]
- Notice of Privacy Practices Form [PDF]
- Notice of Non-Discrimination [PDF]