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(708) 923-1919
McInerney Cares
11824 SW Hwy # 200 Palos Heights, IL 60463(708) 923-1919
12701 West 143rd Street, Suite 250 Homer Glen, IL 60491(708) 923-1919

Patient Forms

Please print and fill out these forms so we can expedite your first visit:

  • Patients Information [ pdf ]
  • Patients Information [ online ]
     
  • Patient Care Notes [ pdf ]
  • Patient Care Notes [ online ]
     
  • Office Policy [ pdf ]
  • Office Policy [ online ]
     
  • Notice of Practice Acknowledgement [ pdf ]
  • Notice of Practice Acknowledgement [ online ]
     
  • Medical History Review Of System Form [ pdf ]
     
  • HIPAA Form [ pdf ]
  • HIPAA Form [ online ]
     
  • Antepartum Record [ pdf ]
  • Pregnancy Dos and Don'ts.pdf [ pdf ]

Adobe Acrobat Reader DownloadIn order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

Patient Education

  • Obstetrics
    • Preconception Counseling
    • Ultrasound Exam
    • First Trimester Screening
    • Prenatal Visits
    • Childbirth Settings
    • Postpartum Care
    • Postpartum Depression
    • High Risk Pregnancies
  • Fertility
    • Infertility
    • Female Sterilization (Tubal Ligation)
    • Family Planning
  • Gynecology
    • Annual Gynecological Exams
    • Pap Smear
    • Contraceptives
    • STI Screenings
    • Menopause
    • Menopausal Hormonal Therapy
  • Gynecological Conditions
    • Ovarian Cysts
    • Urinary Incontinence
    • Hysterectomy
    • Polycystic Ovary Syndrome (PCOS)
    • Uterine Fibroids
    • Heavy Menstrual Periods
    • Vaginal Prolapse

For your convenience, you can email us at [email protected] or reach one of our gynecologists at (708) 923-1919. Fax: (708)923-9922

*Please use email for NON URGENT QUESTIONS, expect a response between 42-78 business hours.

 
(708) 923-1919
11824 SW Hwy # 200 Palos Heights, IL 60463
(708) 923-1919
12701 West 143rd Street, Suite 250 Homer Glen, IL 60491
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