Patient Forms

Forms

Get a head start on your appointment by filling out any relevant paperwork below. Each form is hosted securely on JotForm with HIPAA compliance and opens in a new tab.

Adults

New Patient Paperwork

Complete before your first visit to speed up check-in. Includes intake, medical history, and consent forms.

Open on JotForm

Minors

New Patient (Minor) Paperwork

For patients under 18. A parent or legal guardian must complete and sign the intake before treatment.

Open on JotForm

Program

Weight Loss Paperwork

Required for anyone starting the Genesis Medical Weight Loss Program, medical history and program consent.

Open on JotForm

Specific

Knee Pain Paperwork

For patients coming in for a knee pain consultation, helps our team tailor the exam to your history.

Open on JotForm

Secure & HIPAA-compliant

All forms are hosted on JotForm’s HIPAA infrastructure. Your information stays private.

Need help? Call 630-845-8925

Ready when you are

Schedule a consultation Today!

The team at Genesis Integrative Medicine is here to help you. Please feel free to call us with any questions.

Call 630-845-8925

Our mission

Accepted Insurance Providers

At Genesis Integrative Medicine, we’ve recognized a pervasive challenge in modern healthcare: the fragmentation of treatment and communication among practitioners. Our mission in Geneva, Illinois, is to revolutionize patient care by offering a seamless blend of traditional medical services and alternative therapies all under one roof.