FORM INDEX PAGE

 

click on the pdf icon and make sure to have signed either a). printed copy or b).digital signature

new client demographic

 

consent for treatment

 
 

confidentially & cancellation  

 

release of information form

optional

 

LOCATION 1:

215 North Main Street

Algonquin, IL 60102

Phone: 224-678-9033

Fax: 224-678-9493

Email: Dr.Lendvay@comcast.net

LOCATION 2:

1644 Colonial Parkway

Inverness, IL 60067

Phone: 847-776-4500

Fax: 847-776-4724

Email: Dr.Lendvay@comcast.net

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