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E-Newsletter

Provider Only

Referring a patients to West Suburban Medical Center is easier than ever before. Order forms, patient education tools and more can be accessed from your office. Simply select from the items below, open the pdf document, print a copy and fill it out as you would a traditional hospital form.

General

Physician's Admitting Orders.pdf

Physician Order Form.pdf

Pre-Surgical History and Physical.pdf

Gastroenterology

GI Consulation Request.pdf

Instructions for Outpatient EGD.pdf

Instructions for Your ERCP.pdf

Miralax Prep for Colonoscopy.pdf

MOVIPREP Split Does Prep for Colonoscopy.pdf

PEG Solution Preparation for Colonoscopy.pdf

Preparation for Flexible Sigmoidoscopy.pdf

Radiology

Department of Radiology XRay Exams.pdf

Department of Radiology Medical Imaging Exams PAGE 1.pdf

Department of Radiology Medical Imaging Exams PAGE 2.pdf