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Medlux Rehabilitation & Wellness
  • Call Today: (847) 305-1954
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  • Request an Appointment
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  • Meet the Providers
    • Ricardo A. Knight, MD, MBA
    • Andrew Vo, MD
    • Edward Babigumira, MD
    • Jennifer Walsh, ANP
    • Minal Patel, PA-C
    • Sabrina DeMarco, FNP
    • Dee Sternhagen, FNP
  • Inpatient Services
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    • Physical Medicine
    • Physical Therapy
    • Pain Management
    • Weight Loss Management
    • PRP Therapy
    • Stem Cell Therapy
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Request an Appointment

Please do not use this form if you have an urgent medical problem or you need to reschedule an existing appointment. Instead, contact our office at (847) 305-1954. After you submit your request, our appointment scheduler will respond within 48 hours. See below for forms to complete. Established patients may log in to the patient portal to request appointments and update forms.

Patient Registration Forms

Medlux Rehabilitation & Wellness in Rockford, Illinois welcomes you to our practice. Once you have made your initial appointment, you may preregister by downloading, printing, and completing the forms below. Doing so prior to your visit will help speed up the new patient registration process.

Please be sure to bring all forms with you to your first visit, along with any diagnostic films or other test results that may have been ordered or performed by another physician.

Downloadable Forms:

  • New Patient Information
  • New Patient Pain Questionnaire
  • Medication List
  • Patient Financial Responsibility

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 by clicking on the icon below.
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Medlux Rehabilitation & Wellness

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Blog

Discover the latest news and developments in the field of physical rehabilitation and wellness with our exclusive blog.

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Patient Education

Learn more about the conditions we treat and rehab services provided at Medlux Rehabilitation & Wellness with our A-Z patient education library.

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Medlux Rehabilitation & Wellness

Medlux Rehabilitation & Wellness

345 Executive Parkway | Rockford, Illinois 61107 (847) 305-1954

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Medlux Rehabilitation & Wellness in Rockford, Illinois, is a medical group that focuses on the delivery of physical medicine and rehabilitation services in the Chicagoland area.

  • Home
  • About
    • Careers
    • Back
  • Meet the Providers
    • Ricardo A. Knight, MD, MBA
    • Andrew Vo, MD
    • Edward Babigumira, MD
    • Jennifer Walsh, ANP
    • Minal Patel, PA-C
    • Sabrina DeMarco, FNP
    • Dee Sternhagen, FNP
    • Back
  • Inpatient Services
  • Outpatient Services
    • Physical Medicine
    • Physical Therapy
    • Pain Management
    • Weight Loss Management
    • PRP Therapy
    • Stem Cell Therapy
    • Back
  • Conditions Treated
  • Skilled Nursing Facilities
  • Shop Medlux
  • FAQs
  • Blog
  • Contact & Locations