Forms

Schedule Request
Services and Fees
Insurance Information
Prescription Request
Child History
Consents
Emergency Treatment Release
Financial Agreement
Health Policy
Cancellation Policy
Privacy Notice

 

Insurance & Payments

While we accept most insurance. (Out of Network)

We are ONLY in-network with:

  • Blue Cross . Blue Shield of Illinois (PPO)
  • Aetna
  • TRPN - Tree Rivers Provider Network (discount program)
  • Early Intervention Program (State of Illinois)