All patients are required to sign our Consent for Use and Disclosure of Confidential Health Information Form (HIPAA Form). Please contact our office if you would like this form mailed to your home. Download this form as a .pdf file by clicking on the link to the left: Download Forms.
All patients have the right to review our Notice of Privacy Practices prior to signing this form. However, we reserve the right to change our privacy practices and change the terms of the notice. If you would like to obtain a current version of this notice, please contact our privacy officer:
Crystal Lake & Huntley Locations: Contact Sue Maggio at 815-459-5600
Lake Geneva & Burlington Locations: Contact Mari DiVarco at 262-248-8766.