Thank you for choosing Advocate Good Samaritan Hospital for your upcoming surgical needs.

As a convenience to you, we are now offering our surgical patients the opportunity to complete their Registration and Health History online. Required fields for you to begin this process are your first and last names, date of birth, surgeon’s last name and date of surgery.

You will need to have all of your insurance or worker’s compensation information available in order to complete the Registration. You will also need your medication names and dosages, your doctors’ names and phone numbers as well as answering a variety of questions related to your health to complete your Health History.

This process may take up to 30 minutes to complete. You have the flexibility to complete any one or more pages, save and then come back and finish the rest before submission.

If you have any questions or need assistance with your Registration or Health History, please contact us at (630) 275-1662 or e-mail at:

Finally, within two weeks of your surgery, a nurse will call to confirm your Health History, schedule any testing, and provide education for your upcoming procedure.

Online Registration and Health History

Surgery Search
Surgeon Last Name
Patient Last Name Patient First Name
Patient DOB Surgery Date