What to Bring
When you arrive for your appointments, please make sure to bring the following information:
- Driver’s License or other photo I.D.
- Insurance Card(s)
- List of current medications (i.e. prescription medications and over-the-counter vitamins and supplements)
- Method of Payment
- Medical records pertinent to your care (ultrasound reports, lab results, records from another physician)
Our office hours vary from 7:00 am-7:00 pm, Monday through Friday Our phone hours are from 8:30 am-4:00 pm, Monday through Friday Please call our office to see which Doctors are offering extended hours
For your convenience we accept cash, check, MasterCard, Discover, Visa, and American Express
Payments for co-pays and fees for services rendered are due at the time of service. You are responsible for knowing your insurance limitations and policies, as well as understanding what your financial obligation is (deductible, co-insurance, co-pay’s etc.) Please contact your insurance provider to verify we are in network for your plan prior to your visit. If your insurance requires a referral or authorization for your visit and you do not have this with you at the time of service, your appointment may need to be rescheduled. Please be sure to bring a current copy of your insurance card to each visit. We cannot submit a claim to your insurance company without specific information listed on the card. We are happy to submit your bill to the insurance company; however, ultimately the payment is your responsibility.
Northwestern Lake Forest Hospital, located at 660 N. Westmoreland Road in Lake Forest, Illinois 60045. You can call them at 847-234-5600 or visit them online by clicking here (http://www.lfh.org/).
Please download and complete the fillable patient forms shown below. New patients will need to complete the first five forms. Once you have completed the forms, please print and bring them with you 15 minutes prior to your appointment. You can choose to fax your forms, along with your insurance card to the front desk at 847.234.7765.
- Financial Policy
- Patient Information Sheet
- Medical History Form
- Communication Request
- Privacy Practices Signature
- Notice of Privacy Practices
- Authorization for the Release of Medical Records
- Procedure Verification Form
- Medication Verification Form
- IUD Verification Form
- Nexplanon Forms
- Genetic Testing Codes
- Medications That Can Be Taken During Pregnancy
- Prenatal Record Form
Note: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.
Our office has instituted a 24 hour cancellation policy. The fee is $50. The policy will apply to all NEW patients and existing GYN patients for either annual exams or problem visits. We schedule our appointments in order to maximize the time spent with each patient. Unanticipated no-shows and cancellations leave large gaps in the doctor’s schedules and also increases the wait time, not allowing them to stay on time. All new patients will be asked to leave a credit card number on file while scheduling their first appointment. New patients will be charged for any cancellations less than 24 hours in advance or for no-shows. We understand that your time is valuable, and therefore make every effort to remain on schedule. So please notify us 24 hours in advance if you cannot make your scheduled appointment.
If you are an existing patient (ex. have been previously seen by one of our doctors in the office), there is a physician on-call 24 hours a day, 7 days a week to help you with an urgent medical problem. The after-hours answering system is for calls that are urgent and cannot wait for normal business hours. Please dial 847.234.3250 to be directed to the answering service. If your medical condition is life threatening, call 911. If your problem is not a medical emergency, please call during office hours. Prescription refill requests will be handled only during office hours. Birth control pill prescriptions will not be refilled by the on-call doctor on the weekend.
We respect the time of all our patients. We strive to stay on schedule so that you do not have to wait. If you arrive late to your appointment every effort will be made to see you the same day, however, you may be asked to wait or reschedule your appointment.
Phone Calls & Messages
It is our goal to answer all messages as soon as possible, however, please allow 24 business hours for a return on your call unless it is an emergency. Please leave the reason for your call, as some messages will be handled quickly by the nurse. Please leave your best contact number at the time of your message.
After Hours Calls
The on-call physician can be reached by calling the office phone number to be directed to our answering service. Please leave a phone number that will be available for at least 15 minutes. Please remove all blocks from your telephone as the doctors do block their personal numbers when returning calls. If your phone is blocked this will slow down the response. Please utilize this service in case of emergencies only. Birth control prescriptions will not be refilled during after hours.
Please contact your pharmacy initially for refill requests. If the pharmacist has directed you to contact our office, please be sure to have the pharmacy name, phone number, and prescription number of the previous refill. Requests for prescription refills are only done during office hours and may take up to 48 hours to complete. Please be sure to call at least 4 days before you run out of your medication. Order prescription refills online through our patient portal.
These services are primarily provided from Labcorp and Bio-Reference Laboratories. It is the patient’s responsibility to assure that the insurance will cover labs drawn from these labs. Insurance companies often change their preferred laboratory therefore check your coverage prior to each blood draw. These services are provided for the convenience of our patients and labs requested from our doctors only.
Normal test results will be sent to you via our Patient Portal. Results for blood work and radiology can take a week or more to be returned to us. Pap smear results can take as many as 10-14 days to reach our office. You will receive a phone call by the office/physician for any abnormal test results. Occasionally, you will be asked to return to the office to discuss test results, as a phone consultation may not be appropriate. This may be true for normal test results, as well.
All of our staff members are held up to the highest confidentiality standards. Your medical information will remain completely confidential unless we receive a signed written release from you. Information will not be shared with your spouse or family members unless specific authorization is obtained to do so. If you require your records be sent for medical purposes, we can forward records to your physician or other medical facility. This will be done free of charge for continuity of care, however, records copied for patients, insurance companies, or for any other reason, will be charged a fee.
Most health insurance benefits do not include telephone consultations as a covered health benefit. A telephone consultation is a request by the patient for clinical advice related to a new or distinct medical condition and is not part of the follow up to a condition under active treatment in the office. Charge: Between $50 and $150 depending upon complexity of the request being made and time spent, with a minimum charge of $50 per response. Telephone consultations are also charged if the patient requests and authorizes a discussion of the patient’s condition, treatment, or any other clinical matter with a relative or other physician not part of the active treatment of the patient. The patient must have authorized such communications in writing.
Some health plans require referrals for you to see a specialist. If you plan to see a specialist unrelated to your OB/GYNE health, you must obtain the referral from your Primary Care Physician’s office.