Forms & Policies
Thank you for selecting Mark Gapinski, 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 or use our online appointment request form.
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.
- 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:
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.