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New Patient Paperwork – Chicago/South Loop

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  • New Patient Paperwork – Chicago/South Loop

Please answer the following questions honestly so we can do our best to help you reach your goals.

Yes or No

NEW PATIENT INTAKE

Family History: Please specify members of your family including extended family who have these illnesses.

Current Medications/Prescriptions and Non-Prescriptions

Some of out programs use medications that are not deemed safe to take while pregnant or breastfeeding.

Thank you for filing your new patient paperwork in advance. Your information will be sent to us, and your forms will be ready when you arrive.

About Us

Options Medical Weight Loss™ Center is Chicagoland and the Chandler/Gilbert’s premier weight loss facility. We believe that the true way to not only reach your weight loss goals, but to keep weight off, is by making the proper lifestyle changes with nutrition.

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The material on this website is for informational purposes only and is not a substitute for medical advice by a physician or treatment
for any medical conditions. You should immediately seek professional medical care if you have any concern about your health.
Options Medical Weight Loss™, Options Diet System™, Options HCG System™, “OPTIONS for every BODY™” are registered trademarks of Options Medical Weight Loss.