Medical Forms

OSF Medical Group - Rockford area welcomes all new patients! To assist us in making a smooth transition of care for you and your family, please bring the following information with you when you visit our office for the first time:

• Insurance cards
• Medicare cards
• Illinois Department of Public Aid (IDPA) cards
• Current medications and/or a list of your current medications.

Our office will bill all insurances, but we will collect co-pays and self-pays at the time of service. Please contact your current physician and arrange to have your medical records transferred to the OSF Medical Group office you will be visiting. You may also fill out the following forms and bring them with you to your first visit.

New Patient Forms

• Adult Patient Medical History Form
• Patient Contact Information Form
• Privacy Acknowledgment Form
• Personal Representative Designation Form
• Consent to Release Information for Billing Form

Advanced Directives/Power-of-Attorney Forms

If you have an advance directive such as a Living Will or a Power-of-Attorney for Healthcare, please provide us a copy for your medical record. If you do not currently have advance directives, information and forms are available at your physician's office upon request.