COVID-19 Information Center: get the latest on vaccines, testing, screening, visitor policy and post-COVID support >>

Medical Opinion Request Form

Medical Opinion Request Form

Medical Opinion Request Form

This request form is for those seeking a second, or primary/first, medical opinion. It will take less than five minutes to fill out and will be directed to a worker who will assist you with scheduling an appointment.

*Indicates required information

*
*
*
*
*
*
*
*
Gender

*
Is this request for the Edward Cancer Center in Naperville and Plainfield, or the Nancy W. Knowles Cancer Center in Elmhurst?



*
*
How did you hear about the Second Opinion Clinic?



*
Authentication
   
*

News

View All
Elmhurst Hospital extends straight-A streak in national safety measure Elmhurst Hospital is one of only three hospitals in Illinois and 22 in the U.S. with straight As since the program began in 2012.

If you have reached this screen, your current device or browser is unable to access the full Edward-Elmhurst Health Web site.

To see the full site, please upgrade your browser to the most recent version of Safari, Chrome, Firefox or Internet Explorer. If you cannot upgrade your browser, you can remain on this site.