Intake Form
Intake Form

Save time on your first visit by downloading and completing the patient forms.

The link below will provide you with our patient forms. You can print these out and complete them before you come in for your first visit.

Please click here to download.

**NOTE: You can type directly into these forms then print them out.**

Notice of Privacy Practices - HIPAA Booklet

If you have any questions, please give us a call at 773.586.2768

Sign up for newsletter
Please wait...
Thank you for signing up.
You have been added to our newsletter list.
Yes, I would like to receive newsletters from FYZICAL Therapy and Balance Centers - Chicago.

Leader in the health and wellness space, providing private practices with business systems, operational support, clinical education, and proprietary technology and protocols. FYZICAL® is actively changing the healthcare landscape by providing patients with wellness programs and clinical care in: Fall Prevention, Orthopedic and Vestibular Rehabilitation

Corporate Home