Intake Forms
After a brief 5-minute consultation with our intake coordinator, your intake forms are sent to complete securely inside the patient portal — or download printable PDFs to bring to your visit.
For your privacy, do not email completed forms. Email is not HIPAA-secure. Return forms through the secure patient portal or bring them to your first visit.
Recommended
Complete Intake In The Secure Portal
After booking, you'll be guided through intake, consents, and any clinical screenings inside our HIPAA-secure patient portal — no printing, no scanning, no email.
Download & Bring
Printable Patient Forms
Prefer paper? Download, complete by hand, and bring to your first visit.
Adult New Patient Intake
Demographics, insurance, reason for visit, medications, history.
Please do not submit protected health information through this website. Use the secure portal or contact our office at 312-796-2646.