Lincoln Square

(773) 878-6233

North Shore Surgical Suites

(773) 878-6233

Plum Creek Surgery Center

(219) 273-2570

Wicker Park

(773) 878-6233

Patient Information

Patient Forms

For your convenience, we have made several patient forms available to be downloaded and printed prior to your visit. By completing these forms in advance, you will help us to serve you in a more efficient manner.

Please download and complete the packet of forms below and email to [email protected]


First Visit Guide

When you come for your first visit please remember to obtain and bring the following:

  • Please wear comfortable attire for your appointment
  • Previous x-ray, films, and test results relating to your injury/illness
  • Previous medical records relating to your injury/illness
  • Operative Reports from any previous surgeries
  • Your valid insurance card(s)
  • Referral/authorization from a primary care physician
  • Workers Compensation information
  • Lien attorney information for personal injury cases and auto accidents
  • Patient Information Forms
  • A list of your current medications
  • Information about what treatments and medications have been tried in the past)

Useful Links

  • Lincoln Square
    Lincoln Square

    5616 N. Western Ave.
    Chicago, IL 60659

  • Wicker Park
    Wicker Park

    1431 N. Western Ave., Suite 510
    Chicago, IL 60622

  • North Shore Surgical Suites
    North Shore Surgical Suites

    8400 Lakeview Pkwy #800
    Pleasant Prairie, WI 53158

  • Plum Creek Surgery Center
    Plum Creek Surgery Center

    9200 Calumet Ave Suite N-300
    Munster, IN 46321

ORC Urgent Care

Same Day Appts Available! Call (773) 878-6233

Monday  

8:30 am - 5:00 pm

Tuesday  

8:30 am - 5:00 pm

Wednesday  

8:30 am - 5:00 pm

Thursday  

8:30 am - 5:00 pm

Friday  

8:30 am - 5:00 pm

Saturday  

Closed

Sunday  

Closed