Patient forms
Knowing as much as possible about your child’s health will help us tailor our Healthy Active Living care to their individual needs. Fill out the forms below before scheduling an appointment, indicating if you are applying for the Oak Lawn or Wilmette program.
Choose the most convenient way to return the completed fillable Intake forms below to us, whether that’s by email or fax. Expect a phone call within 5-7 business days to schedule your appointment.
Fax
Print out and send to 708-423-1899; Attn: Dr. Jeremy Daigle/HAL Program
Photograph or scan the completed form and email the file as an attachment to:
amg-healthyactivelivingoaklawn@aah.org.
