Oak Mill Medical Associates
A Medical Home For Families

Patient Information and Privacy

Forms & Policies
  1. Your Personal Information
    Oak Mill Medical Associates values your privacy. We follow all HIPAA guidelines and regulations.

    To access your medical record, please download the Medical Records Request form. Please fill it in completely and you either may bring it with you, mail or fax back to our office at 847-663-9702. Federal law requires you complete the authorization form before we can fulfill your request. When a request is made the office will accumulate the copies and inform the patient of the charges based on the legal copy fee for the year. .

    pdf document HIPAA Privacy & Access Your Medical Record Form (PDF)

  2. Patient Registration
    Patients are required to provide certain information during registration in order for our office to provide treatment and bill insurance for our services. Upon arrival at our office, please have insurance cards and copayments available.

    New patients may print and complete registration forms prior to scheduled appointments by clicking on the forms below.

    pdf documentPatient Registration Form (PDF)

  3. Financial Policy
    Please bring your insurance card to every visit.

    For your convenience, we have answered a variety of commonly-asked financial policy questions below. If you need further information about any of these policies, please ask to speak with the Office Manager.

    How May I Pay?
    We accept payment by cash, check, VISA, MasterCard.

    Which Insurance Plans Do You Contract With?

  4. What Is My Financial Responsibility for Services?
    Your financial responsibility depends on a variety of factors, explained below.

    pdf documentFinancial Policy (PDF)

  5. Cancellations
    As a courtesy, we request cancellations 24 hours prior to the scheduled appointment. A "No Show" fee will be assessed to those who do not contact the office with a cancellation.