Getting Started

Your Name (Parent/Guardian)
Child's First Name
Child's Last Name
Child's Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Which service are you looking for?
Which insurance do you have?
Please note that Westside is not contracted with Medicaid insurance plans.
Which HMO site do you have?
Primary Clinic Preference
Please note that Casting is only done in Orland Park South.
Secondary Clinic Preference
Adding a secondary clinic preference gives us more flexibility in speeding up access to care. Many of our locations are nearby one another.
Please MARK below if you can make any appointment spot work before 3pm on a weekday.
Being open to daytime availability leads to 2-3x faster scheduling. Evening only availability takes longer as those times are in high demand.
How did you HEAR ABOUT US?
Not-submitted
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referral_id
Current Time

Hour Minutes

AM/PM Option
Should be Empty: