Please feel free to fill out the information below and, if you submit contact information, someone will be in contact with you within 24-48 hours. This information is confidential and not sold, shared or in any way personally identifiable to you. If you prefer, you may simply email me.
Prior to your first visit, please download and fill out the Patient Registration Form. If you don't have access to a computer or printer, the form can be printed and filled out upon first visit.
| kjs_patient_registration_5...doc |
Kenneth J. Stanek, PhD, LCPC, BCPC, SC
Licensed Clinical Professional Counselor
4415 W. Harrison, Suite 307, Hillside, IL 60162
Email me
708.439.1327 \ FAX: 708.924.1328
www.kenstanek.net
Licensed Clinical Professional Counselor
4415 W. Harrison, Suite 307, Hillside, IL 60162
Email me
708.439.1327 \ FAX: 708.924.1328
www.kenstanek.net