Advanced Medical and Physical Therapy Programs Combining
The Best of Traditional and Nontraditional Medicine

New Patient Forms & Downloads

Click to download our new patient, information forms.
Please complete all forms prior to your appointment time.

What to bring for your initial visit:
  • Any blood work, MRI, CT scan or XRay results done within the past 6 months.
  • A list of your prescription medications
  • Bring in the bottles of any over the counter supplements you are taking.
  • Any questions you have for the Doctor.
  • Anything else, you think, may be relevant to your visit.
Please arrive 10 minutes early, so we can gather all of your paperwork. If you have not completed your health history, please allow at least 20 minutes to fill out your forms.

ALT-MED strives to keep it's daily schedule on time. Please call the office if you will be late or need to cancel your appointment.

We look forward to seeing you soon!
If I had not entered in this back pain program, I told for sure that I would have to have had back surgery for my three herniated disc's. I have talk to a few coworkers... They had back surgery and I cannot believe the shape they're in... Some are never going to be the same. Some had less severe problems than me and are now on permanent disability. I feel the 99.5% back to normal before the accident.

- Richard Tesler
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ALT-MED Medical and Physical Therapy
1544 Nerge Road • Elk Grove Village, IL 60007
Phone: (847) 923-0046 • Fax: (847) 923-0047

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ALT-MED is a contracted provider with Medicare and BCBS of IL. PPO.
  
Saturday April 19, 2025