Illinois Medical Center
1001 Main Street - 5th Floor
Peoria, Illinois 61606
Patient Information
Patient Forms
Please take the time to review, print and sign the appropriate Patient Procedure form by clicking on the links below. Patients should also review, print and sign the Physician Ownership Disclosure Form.
If you have any questions, please call our office at (309) 495-1144.
For all patients:
Physician Ownership Disclosure
Privacy Practices for Protected Health Information
Patient Rights and Responsibilities
Please select the appropriate form:
Esophagogastroduodenoscopy (EGD) Informed Consent
