Schedule an appointment with Dr. Sypien

or

Call 773-205-2555

Thank you for choosing us for your Healthcare needs. We are always glad to make appointments for you, and we appreciate your interest in Integrative Medicine.

The following forms are available for you to print and fill out prior to your appointment.  The forms are also available in the office to fill out when you arrive.  If the forms are to be filled out in the office please arrive early to allow time to complete them prior to your scheduled appointment.

NEW PATIENTS

• Patient Registration Form

• Financial Policy

• HIPAA Patient Consent Form

• Health History

• Informed Consent for Telemedicine Form

Other Forms

• Authorization for Release of Medical Information

• Receipt of Notice of Privacy Practices Acknowledgement

• Revisit

Please read carefully all other documents:

NOTICE OF PATIENT PRIVACY PRACTICES

TERMS & CONDITIONS

CLINIC POLICY