Patient Information

Medical History Form

Please complete the Medical History Interview Form PDF by clicking on the image.

Para completar el formulario en español, haga clic aquí.

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3241 S. Michigan Ave.

Chicago, IL 60616

312.225.6200

OUR HOURS

Mon - Wed

Thursday

Friday

Saturday

Sunday

8:00 a.m.  -  7:00 p.m.

8:00 a.m.  -  5:00 p.m.

8:00 a.m.  -  1:00 p.m.

8:00 a.m.  -  1:00 p.m.

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