If you are a new patient to our office we will need some paperwork from you. In order to make your first visit with our office as easy as possible for you, we have put the paperwork here on the site so you can download it and fill it in at home. Please ensure you set aside enough time to complete the entire packet. There will also be a few minor forms to sign when you arrive at the office.
Please gather any IMAGING REPORTS (MRI / X-RAY / CT SCAN / Ultrasounds) and recent LAB WORK REPORTS (6-12 months) and either fax or present to the front desk staff for copying upon your arrival. Our fax number is: 630-357-0204.
ADULT NEW PATIENTS (13 and older):
Adult intake – chronic or more involved cases (main forms, click to download and complete this set of forms)
Adult intake – simplified case (acute problem such as recent back or neck pain)
Personal Injury Paperwork (complete if you’ve been in a motor vehicle accident)
CHILD NEW PATIENTS (12 or younger):
Click to download CHILD intake forms
CURRENT PATIENT PROGRESS UPDATE FORMS
Metabolic Assessment Form (fill this out if you are already a patient and need to repeat lab work or nutritional consultations)
Progress Update (complete this form just prior to each re-examination with Dr. Serpe).
RETURNING PATIENTS SHORT FORM UPDATE
Returning patient health history update form
ADDITIONAL CONDITION SPECIFIC FORMS (find your condition and complete this form too):
If you have Vertigo, Dizziness or Balance Problems: Dr. Serpe Vertigo Questionnaire
If you have Fibromyalgia: Fibromyalgia Impact Form
If you have Restless Legs Syndrome: Restless Legs Questionnaire
Thank You.
We look forward to meeting you in the near future.
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