Outpatient Behavioral Services Forms
Thank you for choosing Palos Community Hospital for your Outpatient Behavioral Services. Our expert clinicians are dedicated to providing the finest in evidence-based services, tailored to meet your individual needs.
To help us to provide the best possible treatment to you, we ask you to complete the following two forms:
This comprehensive form is confidential and designed to help us more immediately be of help to you. Though you may feel that parts of the form may not apply to your situation, we ask that you complete the form as thoughtfully, carefully and completely as possible.
This form also needs to be completed as carefully as possible.
Please remember to bring these two completed forms with you for your first appointment. Or, consider faxing them to us ahead of time at 708-226-2621.
If you have these forms with you, you should plan to arrive 15 minutes before your scheduled appointment.
If you do not have these two forms with you and completed, please plan to arrive 45 minutes before your scheduled appointment to allow you time to complete the forms.
