Help your patients change their body while they change their mind

If you think one of your patients can benefit by Inspire’s collaborative approach to weight management can simply complete the Physician Referral form to refer them to our practice. One of our Intake Specialists can contact you or your patient, or you can simply call or e-mail with a question or to make a referral.

If you have a patient who has an eating disorder you can go to our Insight practice (www.insightillinois.com) and review our treatments and therapies.

Whichever treatment you are looking for you can be certain that the healthcare professionals at Inspire or Insight are there to answer your questions and help accommodate your patients.

To help us track your inquiry and provide preliminary information on your referral please fill out this short questionnaire. Please note that Inspire will not and does not share this information.

Doctor Contact Information
*Denotes Required Information

Doctor Name*

Office Phone*

Mobile Phone

Office Address*

e-Mail Address*

Practice/Specialty
Internist
OB/Gyn
Other

Hospital Affiliation(s)

I would like to (check as many as apply):
Make a patient referral
An Inspire Intake Specialist to contact me via e-mail
An Inspire Intake Specialist to call me
More information on Inspire mailed to me
More information e-mailed to me
An Inspire Intake Specialist to contact my patient directly