Patient Forms

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You can help accelerate your visit to one of our DuPage Immediate Care locations by filling out and bringing any applicable paperwork to our urgent care centers rather than having to fill out forms in the waiting room.

Just click on one of the links below for the appropriate form and bring it with you:

New Patient
Registration Form

Patient
Consent Form

Schedule Appointment

Less Wait, More Care

DuPage Immediate Care

1S210 Summit Ave.
Oakbrook Terrace, IL 60181
Ph. 630-282-6002
Fax: 630-282-7322

Walk-in or Reserve an Appointment

If you believe you have a medical emergency, please call 911

New Patient Registration Form

Patient Consent Form

DuPage Immediate Care

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New Patient
Registration Form

Patient
Consent Form