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Patient Forms

For your convenience, University of Illinois Clinics and Health Centers are in the process of placing some of the patient forms online. Due to patient confidentiality, we can not accept the forms via e-mail. We are placing forms online in an Adobe Acrobat format so that you can print them and fill them out at home. Please bring the completed forms with you to your appointment. If you have any questions, please call the clinic you will be visiting.

Registration Form Patients 18 and older
Registration Form Patients under 18
Notice of Privacy Practices Acknowledgment
Authorization to Release Health Information
 

The forms above require Adobe Acrobat Reader for viewing and printing. It is a free download and can be found by clicking the icon below.




 



 

 

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