Thank you for choosing our practice for the health care of your child!
We would like to make the registration process as simple as possible so we are providing these forms (Registration and Financial Policy
) we require at your first visit with us.
If your child has been a patient of a different provider, please request your child's previous health care records to be faxed or mailed to us. Please keep in mind that it may take up to a month for records to be received and processed.
600 S. Randall Road Suite 220
Algonquin, IL 60102
If you have a newborn, first of all Congratulations!
We are excited to start this adventure with you! Please bring the records you were provided when your baby was discharged from the hospital.
As a summary, this is a "quick checklist" of items to bring, for your child's first visit with us:
- Vaccination Records
- Insurance Card
- Credit/Debit/HSA card for billing purposes
- Registration forms (we have them available at the check-in desk as well).
- If a newborn - we need any and all discharge records.
- Medical Records from previous pediatrician's office.
Can't wait to see you at our office!
Please fill out the forms below for your first visit with us.