401 W Ontario St Suite #240
Chicago, IL 60654
DOWNLOAD PATIENT FORMS
- New Patient Paperwork »
- Notice of Privacy Practices Chicago »
- Dancer Questionnaire »
- Runner History Form »
Have an Appointment?
When you schedule an appointment please download all the patient forms off our website and add the additional form if you are an athlete, dancer or runner. Please come 10-15 min early in order to complete paperwork and registration. Please adjust your schedule to allow at least one hour for your initial visit at our office.
We make courteous reminder calls generally within 1-2 days prior to your appointment. Due to occasional voice mail issues patients may not receive the call. Regardless of the receipt of a confirmation call, patients are expected to keep their scheduled appointment time. There is a $45.00 fee for missing your appointment or for cancellations less than 24 hours in advance. We value our patients and want to accommodate them as quickly as possible. Please be courteous and call to cancel at least 24 hours in advance. Giving 24 hours’ notice gives our staff the time needed to offer any cancelled appointments to those on our waiting list.
- All registration forms
- Insurance card
- Referral forms (if applicable to your insurance)
- Shorts or very loose athletic pants that come above the knee
- Athletic shoes; dance/pointe shoes, running, cleats etc.
- Previous X-Rays, MRI films
- Old orthotic devices (even if you are not currently wearing them)
- Anything else that may aid in your consultation and treatment.
Thank you for choosing our office for your Podiatric and Sports Medicine needs. We look forward to seeing you shortly.
Monday: 3 pm to 7 pm
Tuesday: Therapy Services avaliable by appointment only
Thurday: 6:30 am to 12 pm
Street parking is available right outside of the office. Parking gararges as well as parking lots near. You need to call the office from outside building to be buzzed in.
We encourage all patients to schedule visits by appointment. We request that you call in advance so that we can reserve an appointment time for you. If you find it necessary to call after hours, the voice mail will record all evening messages and the office will retrieve and return the calls on the next business day.
We make every effort to keep down the cost of your podiatric care. You can help by paying your co-pays or known balances upon completion of each visit. Our office will gladly give you a detailed receipt and file the claim form to your insurance on your behalf. Some companies apply fixed allowances for certain procedures and others pay a percentage of the charge. If we are part of your insurance plan, we will deduct the insurance adjustments prior to sending you a bill. It is every patient’s responsibility to understand their policy and its coverage details, and to pay any deductible amount, co-insurance or co-pay amount not paid by the insurance company. Any supplies that are dispensed are to be paid for at the time of service. Our office will send out detailed billing statements monthly, and all balances are to be paid immediately and/or at the next office visit if undergoing current treatments. Our office participates in many PPO’s and HMO’s. Please ask for details, we do ask every patient to still check and confirm with their insurance about all coverage polices, as some have restrictions and maximums.
HOSPITAL AFFILIATIONS / SURGICAL CENTERS
- Northwestern Lake Forest Hospital, Lake Forest IL
- Hawthorne Surgical Center, Libertyville IL
- Same Day/25 E. Surgical Center Chicago, IL
Looking for information about our Park City office?
Gurnee Podiatry and Sports Medicine, Park City, IL >