Demographic Sheet
Your basic contact and background information, so we can set up your file.
Download
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Patient forms
Documents & Forms
The forms to complete before your first visit. Download, fill them out, and bring them with you, or we can review them together at the start.
Service Agreement
The agreement that explains how the practice works, including fees and policies.
DownloadIllinois Notice
The State of Illinois notice describing your rights and privacy protections.
DownloadAuthorization Form
Authorization to release or exchange information with another provider, when that is needed.
DownloadSignatures
The consent and signature page that accompanies your intake forms.
DownloadThe files open in Microsoft Word or a compatible app. If you have any trouble opening or printing a form, just call 773-562-3276 or email dps3@uchicago.edu and we will help.
Not sure where to start?
You do not need the paperwork finished to reach out. Send a note and we will take the first step together.
Request a consultation