HomeCare at Northwestern Medicine Regional Medical Group

HomeCare at Northwestern Medicine Regional Medical Group brings compassionate, comprehensive medical care to homebound patients of all ages. Our team approach utilizes primary care physicians and nurse practitioners to provide house calls throughout the western suburbs.

Our Services:

• Physician and mid-level provider house calls
• Assisted living house calls
• Coordination of care with hospitals, home health and social service agencies
• Blood testing
• Electrocardiogram (EKG)
• Gastrostomy tube changes
• Immunizations
• In-home X-rays and ultrasounds
• Oximetry
• Tracheostomy tube changes
• Wound care, including decubitus ulcer care and debridement

For additional information, please contact HomeCare Physicians directly at 630.614.4960.

New Patient Information

Before printing and filling out the new patient forms, verify that your town is served.

Towns served: Bartlett, Batavia, Bloomingdale, Carol Stream, Geneva, Glen Ellyn, Glendale Heights, Hanover Park, Lisle, Lombard, Naperville (North), St. Charles, Warrenville, Wayne, West Chicago, Wheaton, Winfield.

View our service areas by zip code (pdf).

We are honored that you are considering us to care for you or a loved one. To better serve you we need to obtain as much information as possible. Please print out all of the new patient forms and provide all of the requested information. Make sure to sign the forms and fax to HomeCare Physicians at 630.682.3727.

New Patient Instruction Sheets
HCP Office Guidelines Form (pdf)
Universal Consent Instruction Sheet (pdf)
Instructions for Patient Communication Choices (pdf)

Patient Intake Form: You do not need to fill out this form if you already gave all the information to our office over the phone. Please review it to make sure all the information was given.
Demographic Intake Form (pdf)

Medical History Form: The more accurate information we receive the better we are able to care for you. Please fill this out and fax back to the office as soon as possible so the doctor can review it before the visit.
New Patient Medical History Form (pdf)

Release of Information: This allows us to request information from previous doctors/hospitals and also to release our information to other health care providers involved in your care. If you have any concerns signing the form you can wait until the visit to go over it.
Medical Records Release Form (pdf)

Communication Choices: By completing the top part of this form you are giving us permission to leave messages containing medical information at the following phone numbers. In the section below, if desired, please indicate any personal representative/individual who are permitted to receive or know information concerning your healthcare.
Communication Choices (pdf)

Universal Consent: Consent for Treatment/Acknowledgement of Receipt of Privacy Notice/Assignment of Benefits/Authorization to Disclose Medical Information for Payment/Payment Agreement/Authorization to Leave Message: Please read, initial, sign and date form.
Universal Consent Form (pdf)

Please make sure that all forms have been signed by either the patient or patient's Power of Attorney. Forms can be either mailed to HomeCare Physicians, 1800 N. Main Street, Suite 219, Wheaton, IL 60187 or faxed to 630.682.3727.