Forms & Links

This section provides helpful resources for your healthcare needs. Here, you can find important forms, record releases and requests, and other useful links to make your healthcare experience easier.

New Patient Registration

Patient intake forms are essential documents required to establish care with Dr. Thakkar. These forms collect important medical history, current health concerns, and personal details to ensure a comprehensive understanding of each patient’s needs. By completing them accurately, patients help facilitate a smooth first visit, allowing for personalized and effective medical care.

Patient Registration Form

Patient Consent

Patient consent forms are required to authorize medical treatment and ensure patients fully understand their care with Dr. Thakkar. These documents outline procedures, potential risks, and patient rights, allowing for informed decision-making. By signing, patients acknowledge their agreement to treatment plans, fostering transparency and trust in the healthcare process.

Patient Consent Form

Records Release to us

Transferring medical records from a previous provider to Dr. Thakkar ensures continuity of care and a complete health history review. This process allows the office to access past diagnoses, treatments, and test results, helping to create a more informed and personalized treatment plan. Patients must complete a records release authorization to facilitate this secure transfer.

Records to us form

High School Physical

A pre-participation examination (PPE) is required by the Illinois High School Association (IHSA) for students to participate in school sports. This exam assesses overall health, identifies potential risks, and ensures athletes are physically prepared for competition. Conducted by Dr. Thakkar, the PPE helps promote safety and prevent injuries, keeping students active and healthy throughout the season.

High school Physical form

Child Health Exam

The State of Illinois requires a Certificate of Child Health Examination for children enrolling in daycare and school. This exam ensures that children meet health and immunization requirements, helping to prevent the spread of illness and promote overall well-being. Dr. Thakkar provides these comprehensive evaluations to ensure compliance with state regulations and support children’s long-term health.

IL State Child Exam form

Records Release from us

A records release form is required to authorize the transfer of medical records from Dr. Thakkar’s office to another healthcare provider or organization. This document ensures patient privacy and compliance with medical record regulations while facilitating continuity of care. Completing this form allows for a secure and timely transfer of health information as needed.

Records from us form

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