Privacy is a central tenant in our relationship.

As doctors, the trust you place with us in sharing your concerns and personal information is an honor. We value and respect your privacy. We will not disclose any personal information about you without your consent.

We ask that all patients sign our Consent for Use and Disclosure of Confidential Health Information Form (HIPAA Form). Please contact our office if you would like this form mailed to your home. To download the form, go to Online Forms. The HIPAA Form is part of the Patient Registration Packet download under Option 2.

All patients have the right to review our Notice of Privacy Practices prior to signing this form. However, we reserve the right to change our privacy practices and change the terms of the notice. If you would like to obtain a current version of this notice, please contact our office:

Lake Geneva & Burlington Locations: 262-248-8766

Crystal Lake & Huntley Locations: 815-459-5600

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