Surgeons of Northern Illinois

General surgeons dedicated to providing quality surgical services to Lake County, IL

New Patient Forms

In order to serve you better we ask that the forms below be completed at your initial visit to the office. It may be easier for you to complete them in advance and bring them with you to your first appointment. For your convenience, we provide the forms in pdf format below. Click each icon to download and print each form. Or choose the "New Surgery Patient Forms" or "New Bariatric Forms" for all documents together.

You are able to fill out the forms on-line, however all forms will need to be printed, for your security. For mobile devices, you will need to download a free Adobe application for this function to work. Click here to download for iOS or Android.

Patient Information Form                   Health History Form
Financial Policy   HIPAA Consent Form
New Bariatric Forms   New Surgery Patient Forms

You will need a free program that already is installed on most computers in order to read the above files. If you do not have this program you may download it by clicking on the icon below: