1030 N Clark St, 4th floor
(312) 943-6964
Forms
To transfer records in, please print this form and send it to your previous doctor. They can fax records to us directly at (312) 943-6924
To transfer records to a new practice fill out this form.
If your child needs a sports form please complete this questionnaire. It also may be done in MyChart. Please note, they must have had a physical in our office in the last 12 months
You may fill out your patient registration form ahead of time if you'd like. You can bring it into the office or email it to us ahead of time at cahaforms@cahadr.com.
Patients 12 and above must fill out a MyChart authorization form to access the portal. Click this button and download the applicable form on the right side of the page, "Other Community Pediatrics or Pediatrician Practice," and email it to us at cahaforms@cahadr.com