New Patients

New to Kids Health Partners? Check out the answers to our most Frequently Asked Questions. This is a helpful guide for expectant parents and parents of patients of all ages.

Downloadable Forms

Before arriving at Kids Health Partners, please download, review and complete the following forms:

Kids Health Partners Registration Form:
KHP Patient Registration Form

Kids Health Partners Financial Policy:
KHP Financial Policy

Kids Health Partners Medical Form:
KHP New Patient Medical Info Form

Kids Health Partners Notice of Privacy Practices:
KHP Notice of Privacy Practices

Kids Health Partners Receipt of Privacy Practices Form:
KHP Receipt of Privacy Practices Acknowledgment

Other helpful forms:

State of Illinois School Form:
Illinois Certificate of Child Health Examination

Authorization for Release of Patient Health Information (To request patient health records from Kids Health Partners OR to request patient health records from another doctor to be provided to Kids Health Partners):
Authorization-for-Release-of-Patient-Health-Information.pdf

Consent/Authorization for Medical Treatment of Minors (To use if a relative, nanny, etc may be bringing a minor to our office for treatment without a parent/guardian):
Consent-Authorization for Medical Treatment of Minors.pdf

Hospital Affiliations

  • Ann & Robert H. Lurie Children’s Hospital of Chicago (formerly Children’s Memorial Hospital)
  • Evanston Hospital- NorthShore University Health System

Kids Health Partners

4611 Golf Rd.
Skokie, IL 60076
(847) 677-7250

Copyright © 2017 Kids Health Partners
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