Phone: (773) 229-2373
Fax: (773) 229-2376
Email: jcreyespediatrics@gmail.com
6745 W 63rd St., Chicago, IL 60638
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Patient Forms & Resources

Complete forms ahead of time to streamline your visit.

New Patient Registration (PDF)

Basic registration details to help us get to know your family.

Download Form

Immunization Records Request (PDF)

Authorize release of vaccination records from prior providers.

Download Form

Sports Physical Form (PDF)

Bring this form to your visit so we can complete it for sports.

Download Form

Authorization to bring patient (PDF)

Bring this form to your visit if you are bringing a patient who is not your child.

Download Form

Helpful Resources

We share visit tips, developmental guidance, and local resources during appointments. Call us if you need anything before your visit.