Appointment Request

Home/Appointment Request

This appointment form is to schedule non-urgent or routine gynecology appointments. Any obstetrical appointments will need to be made by phone.

If you have an urgent medical issue please call the office directly at (312) 751-7515.

Please allow 24 hours for staff to contact you regarding your appointment request. You will need to confirm the appointment offered to you by phone or email.

If you need to cancel an appointment less than 24 hours in advance, you will be subject to a $75.00 cancellation fee. All cancellations must be done during normal business hours. Our answering service will not take messages regarding appointments.

  • Desired Dates (please give 2-3 choices)