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About Us
- Patient Stories*
Find Care*
- Locations
- Providers
Services
Patient Resources*
Women’s Health Education Center
- Health Concerns & Symptoms
- Resource Library
  - Week by Week Pregnancy Guide
Contact Us

Gynecology
Obstetrics & Pregnancy
Pelvic Floor & Bladder Program
Weight Loss Program
Minimally Invasive Surgery
Diagnostics & Imaging
Wellness & Aesthetics

Gynecology
Obstetrics & Pregnancy
Pelvic Floor & Bladder Program
Weight Loss Program
Minimally Invasive Surgery
Diagnostics & Imaging
Wellness & Aesthetics

WomanCare - Annual & Preventive Care - Banner

Annual & Preventive Care

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomenCare - Period & Hormone Health-1

Period & Hormone Health

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Contraception & Family Planning - Banner

Contraception & Family Planning

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Sexual Health - Banner

Sexual Health

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Fertility Treatment - Banner

Fertility Treatment

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Menopause Management

Menopause Management

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Gyn Ultrasound

GYN Ultrasound

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Midwifery

Midwifery*

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare- Pregnancy Care

Pregnancy Care

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WHS - High Risk Pregnancy

High-Risk*

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Prenatal Care

Prenatal Care

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Labor & Delivery jpeg

Labor & Delivery

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WHS - Postpartum - What is Postpartum Care_

Postpartum

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Pelvic Pain

Pelvic Pain

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare -Biofeedback Therapy

Biofeedback Therapy

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare -Urinary Incontinence

Urinary Incontinence

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Colposcopy - Banner copy

Colposcopy

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Laparoscopy

Laparoscopy

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare-Hysterectomy

Hysterectomy

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Endometrial Ablation

Endometrial Ablation

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - LEEP

LEEP

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare-Myomectomy

Myomectomy

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Laser Vaginal Rejuvenation

Laser Vaginal Rejuvenation

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Hysteroscopy

Hysteroscopy

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - OB Ultrasound

OB Ultrasound

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Gyn Ultrasound

GYN Ultrasound

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Urodynamics - Banner

Urodynamics

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Functional Medicine - Banner

Functional Medicine

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare- Diet&Nutrition - Banner

Diet & Nutrition

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Coolscupting- What is Coolsculpting

CoolSculpting

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

WomanCare - Aesthetics - Banner

Aesthetics

Support for incontinence, pelvic pain, and other urogynecology concerns with a strong focus on therapeutic treatment.

Forms & Records

The forms can either be typed on or written on. Please use only black or blue ink when filling out patient forms.

New Patient - Gynecology

Registration Form (English)
Registration Form (Spanish)
Authorization Form (English)
Authorization Form (Spanish)
Health History (English)
Health History (Spanish)
Financial Form (English)
Financial Form (Spanish)
Communication Waiver

Established Patient - Annual

Registration Form (English)
Registration Form (Spanish)
Authorization Form (English)
Authorization Form (Spanish)
Financial Form (English)
Financial Form (Spanish)
Communication Waiver

Nutritionist Appointments

Prenatal Nutrition
General Nutrition
Online Symptom Survey

Health Profile

Ideal Protein Health Profile

New Patient - Obstetrics

Registration Form (English)
Registration Form (Spanish)
Authorization Form (English)
Authorization Form (Spanish)
Prenatal Questionnaire (English)
Prenatal Questionnaire (English)
Facts about Cystic Fibrosis DNA Carrier Testing
Depression Questionnaire
Financial Form (English)
Financial Form (Spanish)
Communication Waiver

Adolescents

What To Expect At Teens First Visit

Privacy Information

Notice of Privacy Practices

Release Forms

Authorization Form for Release of Confidential Health Information
Authorization Form for Release of Outside Records

Dr. Hetal Shah | Functional Medicine

Screening Questionnaire
Sleep Apnea Screening Questionnaire

If you have any questions, please call a WomanCare office that you visit. Or visit our contact page to leave us a message.

If you have a life-threatening emergency, please call 911 immediately.

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Arlington Heights (Central Rd)

(847) 392-9191
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(847) 221-4900
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(847) 221-4300

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