Patient Resources


The following are patient resources, forms that new patients may fill out before their appointment. Please print out these forms, fill out, and bring to your appointment. If you are not able to print and fill out certain questions, we can assist you in the office. 

Patient Registration Form
Medical History Form
Medical Record Release Form
Notice of Privacy Policy
Financial Policy Lincoln Park OBGYN

For patients requiring prior records or records from our office, please print the appropriate form from below, fill out and either fax or email to our office, so we can assist you accordingly. Any request for medical records requires a formal form with a signature. Please be aware that it may take up to 1 week to provide with the requested documents. Alternatively, you may access Patient Portal to access your records for your convenience. In order to be able to access Patient Portal, please call our office to obtain login information. If you have any questions related to the above medical records or prescriptions for medications, please feel free to contact us.


Other Patient Resources 

Prescription Refill 

To request a refill on an existing prescription, please call our office at (773) 880-6064 or
submit a request form online. Generally, prescriptions for the purpose of prevention and contraception can be considered for online refill, otherwise please schedule an appointment to discuss your concerns. To schedule an appointment, you can visit the following link. If you cannot find a convenient appointment, you can call or email so we can accommodate your request.

Important Websites:

Below you can find helpful websites for your education.

American Congress of Obstetricians and Gynecologists
American Urogynecologic Association
American Association of Gynecologic Laparoscopists
Intuitive Surgical
National Cancer Institute




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