If you have not received your packet, please click on the link below to a PDF file of our Preregistration Form. Print this form and complete with as much information as possible.

GSC Preregistration Form (PDF version - requires Adobe Acrobat Reader)

GSC Preregistration Form (Microsoft Word version)

When you have completed this form please fax it to us at 847.299.2297. Faxing a copy of your insurance card will also help us to insure your surgery will be covered under your health plan.