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


    Shorewood Location

    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 America

    Click Here For Holiday Hours

    Joliet Location

    1508 Essington Rd, Unit 5,
    Joliet IL 60435

    Monday - Sunday
    H: 9 a.m. - 9 p.m.

    P: 815.733.5952

    Next to Walgreens, former budget golf building

    Click Here For Holiday Hours