New Patient Paperwork
Crystal Lake Family Wellness offers our patient form(s) online so they can be completed in the convenience of your own home or office.
- All forms are PDF files. You will need AdobeReader® to view them.
- If you do not already have AdobeReader® installed on your computer,
Click Here to download. - Download the necessary form(s), print them out and fill in the required information.
- Bring the necessary form(s) to your appointment.
New Patient Health History (ages 12 and older)
Pediatric New Patient Health History (ages 11 and younger)
Monday
9:00am - 11:00am
3:00pm - 6:00pm
Tuesday
3:00pm - 6:00pm
Wednesday
9:00am - 11:00am
3:00pm - 6:00pm
Thursday
9:00am - 11:00am
3:00pm - 6:00pm
Friday
Closed
Saturday & Sunday
Closed
Crystal Lake Family Wellness
4777 Northwest Highway Suite C
Crystal Lake, IL 60014
(815) 788-7504