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The physicians and staff of Lake County General & Vascular Surgery welcome you. Serving new patients requires some background information regarding your medical history
and establishing your permission. Please take a moment to download, print and complete these forms and then bring them with you for your appointment.
New Patient Form
MS Word : 22kb
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Medical History Form
MS Word : 22kb
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Patient Authorization Form
MS Word : 25kb
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Privacy Acknowledgement
MS Word : 22kb
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Please feel free to contact our staff should you have any questions during the completion of the forms. We can be reached at 847-816-1966 and 847-856-2525.
Our offices are very easy to find. Click here for maps to our two locations.
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