Patient Forms

We are happy to provide our office forms for convenient download on your home computer. If you are a new patient, please print the registration form below and bring it with you to your first appointment.  Moved? We have included the record release forms for transfer of your child's medical records. In accordance with the Cares Act, all records are required to be available in the My Chart Portal. You need to sign up for the My Chart Portal . If you have a student athlete, you will find the athletic form needed for most schools. Questions about which forms you need? Please call our office and our courteous staff will assist you. If you would like to e-mail your paperwork request, you may do so at [email protected]

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Chicago Office Children's Healthcare Associates
2900 N Ashland Ave.
Chicago, IL 60657
Phone: (773) 348-8300
Fax: (773) 348-7163
Northbrook Office Children's Healthcare Associates
1535 Lake Cook Rd. Suite 101
Northbrook, IL 60062
Phone: (847) 480-1500
Fax: (847) 480-1510