6145 N Northwest Hwy
Patients Resources
Preparing for a Clinic Visit
If you are a new patient, to best utilize time, you are encouraged to bring the enclosed forms completed with you to your appointment.
Patient Forms
The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save a significant amount of time during your visit.
Click the links below to open and/or print each document:
- Documents
What to Bring to Your
Appointment
- Picture ID
- All Insurance Information
- Required Referral Information or Letters if applicable
- Any Required Deductibles / Co-Payments
- Appointment
Important Notes Before Your Appointment
- Completing the required forms before your visit will reduce your total visit time.
- Please allow extra time for parking availability varies with each clinic location.
- Clinic registration is done by appointment time. To minimize your wait, we recommend that you do not arrive more than 20 minutes prior to your appointment.
Payment Options
For your convenience, we accept checks and all major credit cards.
Cancellation Policy
If you are unable to keep an appointment, we ask that you kindly provide us with at least 24 hours’ notice. This courtesy, on your part, will make it possible to give your appointment to another patient. There is a $200 cancellation fee for patients who miss appointment or do not provide 24-hour notice.
Insurance
At Chicago Institute for Neuropathic Pain, our roster of insurance plans and options is comprehensive. We accept Medicare, Worker’s Compensation, most HMOs, most PPOs, and many Liens. Every patient, regardless of their insurance type, receives the same efficient, effective and friendly service and medical care.
