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

Get in Touch


Emediate Cure Quick Care

1039 Brook Forest Ave., Shorewood, IL 60586
Monday - Sunday
H: 9 a.m. - 9 p.m.
P: 815.733.5952
Located on Rt. 59 two blocks north of
Black Rd. next to Massage Envy facing
Target and Bank of Americas
Click here Holiday Hours

New Joliet Location Opening Early 2019

1508 Essington Rd, Unit 5
Joliet IL 60435
Next to Walgreens, former budget golf building
Monday - Sunday
H: 9 a.m. - 9 p.m.
P: 815.733.5952
More Details to Come!

Click Here For Holiday Hours