standard-title Forms


Patients are encouraged to download and fill out any of the applicable forms prior to their visit. Having these filled out in advance will decrease waiting time in the office.

New patients will want to download all of these forms. Please review carefully, and if you have questions we will be happy to answer them during your visit.

If there are medical records from other doctors that you would like to have transferred to one of our providers at PCMA, please fill out a Medical Records Release form and bring with to your visit. You will need to fill out a separate form for each doctor that you have seen in the past. Our staff will take care of procuring your records once we have the signed release forms.



Office Address: Primary Care Medical Associates
1460 N Halsted St, Ste 202
Chicago, IL 60642-2612

Fax Number: 773-871-3608
Telephone: 773-871-4409