Below are forms for new patients that can be downloaded and completed prior to your first appointment with us.

Patient Registration
CMG Patient Registration v2.pdf
Adobe Acrobat Document 156.9 KB
Medical History
CMG Patient Medical History v2.pdf
Adobe Acrobat Document 173.7 KB

NICHQ Vanderbilt Assessments are used by our providers to help diagnose and monitor patients with ADHD.

Vanderbilt Initial Assessment Questionnaires
Vanderbilt Initial Assessment Parent & T
Adobe Acrobat Document 308.4 KB
Vanderbilt Follow-up Assessment Questionnaires
Vanderbilt Follow-up Assessment Parent &
Adobe Acrobat Document 498.2 KB

A request for release of medical records must be completed and signed before medical records can be transferred.  Below are forms for both requesting records from a previous medical provider to be mailed to our office, as well as a form authorizing CMG to provide your child's medical record to a third party.

Release of Medical Records to CMG
HIPAA Release to CMG.pdf
Adobe Acrobat Document 99.1 KB
Release of Medical Records from CMG
HIPAA Release From CMG.pdf
Adobe Acrobat Document 173.1 KB

P: 847-658-6065

F: 847-658-6136


301 N Randall Rd

Lake in the Hills, IL 60156

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11/02/21:  Pfizer COVID vaccine approved for EUA in kids 5 through 11




 FAQ from our Providers


Monday 5-7pm

Tuesday 4-6pm

Wednesday 5-7pm

Saturday 8am-Noon

IDPH News Release 11/03/2021
IDPH adopts CDC Recommendations
Adobe Acrobat Document 125.9 KB



Open Letter to Parents
VPS 1.1.16.pdf
Adobe Acrobat Document 136.6 KB


Required Vaccines for IL Schools
Adobe Acrobat Document 180.9 KB