For more information or to schedule an appointment, please call:
If you are new patient to one of our 24 locations, please print and complete the registration forms and present them to the Patient Service Representative at the front desk. If you are an existing patient, you need to provide updated information at least annually by printing and completing these forms prior to your appointment.
Items to bring to your appointment:
- Current Medicaid card
- Insurance card (Information will be verified to determine co-pays and deductibles)
- Medicare card and applicable co-pay (Medicare co-pay $10; nominal fee $25)
- Picture ID (Driver’s license, passport or school ID)
- Sliding-fee scale applicants must bring required proof of income for the one-month period or an annual tax return.
- Verification of your current address and phone number is also required (power bill, letter from social security, phone bill, etc.)
Please submit reports of patient safety events to The Joint Commission as follows:
- At http://www.jointcommission.org/, using the “Report a Patient Safety Event” link in the “Action Center” on the home page of the website.
- By fax to 630-792-5636.
- By mail to: The Office of Quality and Patient Safety (OQPS), The Joint Commission, One Renaissance Boulevard, Oakbrook Terrace, Illinois 60181.
NOTE: Reports of patient safety events to The Joint Commission must include of Quality of Life Health Services, name health center location , street address, city and state.