Patient Forms

Patient Forms

Emediate Cure makes it simple by providing a number of options to deal with patient forms. You can print out the forms below and bring them in filled out prior to your visit. The forms can be completed online through our Patient Portal by clicking here.  They can also be filled out at our office with the assistance of one our staff members if needed. If you have any questions, please contact us at 815.733.5952.

Emediate Cure Registration Form

Sports Physical Form

Medical Release Form