SAME OR NEXT DAY APPOINTMENTS AVAILABLE!

Chicago: 312-997-5522

Las Vegas: 702-800-2723

Contact

Physician Referral Form

* Patient First Name :

* Patient Last Name :

* Patient Phone Number :

* Patient E-mail Address :

* Referring Physician First Name :

* Referring Physician Last Name :

* Referring Physician Phone Number :

Referring Physician Email :

Location :

Questions or Comments:

Captcha :

Chicago

29 East Madison St. Suite 1640
Chicago, IL 60602

Email:
Phone: 312-997-5522
Fax: 312-277-3223

Monday – Thursday: 8:30am to 5:30pm
Friday: 9:30am to 5:30pm
Saturday – Sunday: Closed

In the Loop one block west of Millennium Park

e7health.com/chicago

Las Vegas – Southeast

500 East Windmill Lane, Suite 155
Las Vegas, NV 89123

Email:
Phone: 702-800-2723
Fax: 702-921-9461

Monday - Friday: 8:30am to 5:30pm
Saturday - Sunday: Closed

South of McCarran. Across from Vons

e7health.com/lasvegas

Las Vegas – Northwest

2051 N. Rainbow Blvd, Suite 100
Las Vegas, NV 89108

Email:
Phone: 702-800-2723
Fax: 702-921-9461

Monday - Thursday: 8:30am to 5:30pm
Friday: 9:00am to 5:30pm
Saturday - Sunday: Closed

Rainbow Promenade Shopping Center

e7health.com/lasvegas

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Child Supervision

Plan ahead; Children must be supervised while at our centers. Children may not join you inside the collection area or patient rooms during a drug screen, phlebotomy or injections for safety reasons.

SAME OR NEXT DAY APPOINTMENTS AVAILABLE!

Chicago: 312-997-5522

Las Vegas: 702-800-2723

Physician Referral Form

Please check all that apply:

Drug Testing

Physical Exams

Vaccines

Blood Work

Travel Services

Other Services