UIC FGICU | Healthcare Providers

To refer a patient to the FGICU, please provide the following information:

Patient's Name
Date of Birth
Adress
City	State Zip Code
Home Phone	Cell Phone
Insurance Company
Name of Insured
Insurance Phone
Referring Provider
Referring Provider's Address
City	State Zip Code
Referring Provider's Phone	Fax
Reason for Referral
Documents that will be faxed:	Patient Exam/ Medical Records Copy (front and back) of Insurance Card Insurance preauthorization, If applicable Other
Notes for Genetic Counselor

You may send this information to:
Jessica Grzybowski, Genetic Counselor
Office Phone: 312-413-7330
Fax: 312-996-5103
Email: jgrzy@uic.edu
Office Address: 840 South Wood Street (MC 716)
Digestive Diseases and Nutrition Room 740
Chicago, IL 60612

To schedule an appointment for your patient:
Please call our genetic counselor, Jessica Grzybowski
Phone: 312-413-7330
Email: jgrzy@uic.edu.

We provide comprehensive state-of-the-art care for all members of families that have a high risk for developing gastrointestinal or other types of related cancers because of an inherited predisposition.

Referring a Patient

We provide comprehensive state-of-the-art care for all members of families that have a high risk for developing gastrointestinal or other types of related cancers because of an inherited predisposition.