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Practice Name

Synergy Health Associates

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Primary Location
666 Dundee Road Suite 307
Northbrook, IL 60062
Phone: 847-897-8888
Fax: 847-897-8890

Office Hours

DayOpenClosed
Monday9:005:00
Tuesday9:007:00
Wednesday9:005:00
Thursday9:007:00
Friday9:005:00
Saturday8:0012:00
SundayBy AppointmentBy Appointment
Main Content

Synergy Health Associates offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form 


Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form


Notice of Privacy Practices for Dr. Jordan Grumet, Home Base Medical

Download & Print Form



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Office Hours

DayOpenClosed
Monday9:005:00
Tuesday9:007:00
Wednesday9:005:00
Thursday9:007:00
Friday9:005:00
Saturday8:0012:00
SundayBy AppointmentBy Appointment

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Office Hours

DayOpenClosed
Monday9:005:00
Tuesday9:007:00
Wednesday9:005:00
Thursday9:007:00
Friday9:005:00
Saturday8:0012:00
SundayBy AppointmentBy Appointment

Contact

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Synergy Health Associates
666 Dundee Road Suite 307
Northbrook, IL 60062
Get Directions
  • Phone: 847-897-8888
  • Fax: 847-897-8890
  • Email Us
Community Content
Member Wellness