Patient Forms

Patient Medical Forms

- Family Primary Healthcare

- Two Convenient Locations

- Fast & Flexible Scheduling

- In-Office Lab Work

- Ultrasound Imaging

Be Ready for Your First Visit With Us

Please print and fill out the new patient medical forms before your first visit to Regency Medical Center P.C. If you have any additional questions, please call (847) 726-0774.

Barrington Office

22285 N. Pepper Rd. Suite 302

Barrington, IL 60010

847-726-0774

Mon - Fri: 8:00 am - 6:00 pm
Saturday: 8:00 am - 12:00 pm
Sunday: Closed

Open every other Saturday

Palatine Office

675 N. North Court, #180

Palatine, IL 60067

675 N. North Court, #180

Palatine, IL 60067

847-726-0774

Mon, Wed, Thu, Fri: 8:00 am - 2:00 pm
Tuesday: 8:00 am - 6:00 pm
Sat - Sun: Closed

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