Access your medical record ( EMR):

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Save time and stay informed 

At Your Personal Doctor, we strive to make it as easy as possible for you to get the comprehensive, experienced, and advanced care you need to protect your health. With that in mind, we’ve made all the necessary forms and information available to you for easy download. But if you have any questions, please feel free to call us at 847-818-7700.

Registration Medical Form    

Registration Non-Medical Form

Medical History Form

Release Information Form

Office Policy Rules HIPAA For Insured Patients

Medical Services Price List

Interested in learning more about our

HEALTH, WELLNESS, and BEAUTY CARE?

Call us for a free consultation, 847-818-7700, or schedule an appointment with your personal advisor today.

Find out if we accept your insurance plan

Your Personal Doctor does accept the majority of the insurance providers in the area where the clinic is located. Please contact your insurance provider to see if we are in the network with your plan. On the front or the back of your insurance card, you will find a phone number that will allow you to contact your insurance provider to determine if we are in or out of network.

Interested in learning more about our

HEALTH, WELLNESS, and BEAUTY CARE?

Call us for a free consultation, at 847-818-7700, or schedule an appointment with your personal advisor today.