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The Illinois Neurological Institute welcomes all new patients! To assist us in making a smooth transition of care for you and your family, please bring the following information with you when you visit=Images= | Hand writing on forms our office for the first time:

Adults (18 years old or older)

  • Insurance cards
  • Medicare cards
  • Illinois Department of Public Aid (IDPA) cards
  • A list of your current medications.

Our office will bill all insurance. You may also fill out the following forms and bring them with you to your first visit:

=Images= | PDF File Consent For Release Of Information

=Images= | PDF File Patient Health History

 

Children (Under 18)

  • Insurance cards
  • Illinois Department of Public Aid (IDPA) cards
  • A list of child's current medications.
  • Guardianship papers (if applicable)

Our office will bill all insurances. You may also fill out the following forms and bring them with you to your first visit:

=Images= | PDF File Consent For Release Of Information

=Images= | PDF File Patient Health History

=Images= | PDF File Parental Consent Form