New Patient Forms (all forms combined)
Please print and complete all forms and bring them with you to your first scheduled appointment.
Advocate Power of Attorney
Authorization to Release Protected Health Information
Health Insurance Information
Patient Self Assessment
Venous Health History
Patient Acknowledgement Form
Please arrive 15 minutes prior to your appointment time in order that our staff will be able to make sure you are ready for the doctor at your scheduled time. When you come to your appointment please make sure you bring your insurance card, a picture ID, a current list of your medications including dosage and frequency and any copay or co-insurance due.
Please provide us with 24 hours notice if you will not be able to keep your scheduled appointments. There is a $50.00 cancellation fee for appointments cancelled or rescheduled with less than 24 hours notice. This will provide us with enough time to reach out to other patients waiting for appointments with the doctor. Thank you for your assistance in this matter.
We do accept most major insurance plans. Please contact the provider member service department at your insurance company to confirm our participation in your network.
Should you need a refill on your prescription please contact your pharmacy before calling the office. The pharmacy will contact the doctor if additional refills or clarification is needed. If the doctor has not seen you within the last 6 months an appointment may be necessary in order to be able to provide the best medical care possible for our patient.
If you are being referred from another provider and your insurance requires referrals, it is the patient’s responsibility to make sure that the referral is at the office prior to the visit. Patients should also be aware of any tests that would require pre-authorizations and confirm that they have been received prior to testing.
Illinois Cardiovascular Specialists does not have laboratory facilities in our office. If the doctor suggests that a lab test is necessary you can have the test done at any laboratory facility authorized by your insurance company. Results will be fax’d to the doctor when the tests are complete. The office will call you with the results. If you do not hear from us within ten (10) days of having your tests done, please call the office.