Forms & Policies

Thank you for selecting Mark Gapinski, MD and Kevin Hussey, MD for your obstetrical and/or gynecologic care. To schedule an appointment at our Winfield, Illinois OB/GYN office, call us at (630) 462-4963.

Once you have scheduled your appointment, we recommend that you download and complete the new patient forms below. To complete your registration, we request the forms be returned to our office prior to your appointment.

Downloadable Forms:

• New Patient Intake Forms
• Authorization to Release Medical Records
• Notice of Privacy Practices
• Patient Bill of Rights
• Billing Policy

How to handle bumps in the road:

• First trimester 
• Second trimester
• Third trimester

Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free.