New Patients
Palatine Wellness Group offers our patient form online so you can complete it in the convenience of your own home or office.

* If you do not already have AdobeReader installed on your computer, click here to download.

* Download the necessary form, print it out and fill in the required information.

* Fax us your printed and completed form or bring it with you to your appointment.

Patient Application For Treatment
Call Palatine Wellness Group
at (847) 776-9700 today for your
Patient Appointment Hours:

Mon       9-12   and 3-7
Tues       3-7
Wed     9-12   and 3-7
Thurs                 3-7
Fri        9-12   and 3-6
Sat       9-11