Website privacy
A minimal-information inquiry process
The public form is intentionally limited to contact and routing information. It is not a medical intake form or a patient portal.
Information collected through the general inquiry form
The form asks for a name, phone number, optional email, service ZIP code, requester type, general request category, language, contact preference, and optional best contact time.
Information the form does not request
Do not submit dates of birth, diagnoses, symptoms, full home addresses, insurance numbers, medical record numbers, medications, records, images, or attachments.
How general inquiry information is used
Authorized staff may use it to route the request, check general service availability, and contact the requester. Submission does not establish a clinician-patient relationship or confirm an appointment.
Website and form providers
The website hosting or form-processing provider may process and retain form submissions to deliver them to authorized practice staff. Access, retention, notification, and deletion settings should be reviewed regularly.
Referrals and private medical information
Use secure fax 773-277-3371 for approved patient referral materials. Do not send patient information to the public form or general email.
Questions
For website privacy questions, call 773-302-7237 or email illinoismobilefootcare3@gmail.com without including medical details.