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  • Authorization For Release Of Medical Information - Northwestern ... - Nwhealth

Get Authorization For Release Of Medical Information - Northwestern ... - Nwhealth

AUTHORIZATION FOR RELEASE OF MEDICAL INFORMATION Patient: Name: Home Phone: Previous name under which chart may be listed: Address: City: Social Security # Treating Doctor's Name: Day Phone: State:.

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Northwestern Medicine McHenry Hospital is a nationally recognized 143 licensed bed, acute care teaching hospital located in McHenry, Illinois, with more than 600 physicians in 70 specialties who provide comprehensive medical care.

Northwestern Memorial Hospital is an academic medical center in the heart of downtown Chicago with physicians, surgeons and caregivers representing nearly every medical specialty.

Rankings & Ratings Cancer. #9. in the Nation. ... Cardiology & Heart Surgery. #8. in the Nation. ... Diabetes & Endocrinology. #10. in the Nation. ... Ear, Nose & Throat. Not Ranked. Not Ranked. ... Gastroenterology & GI Surgery. #7. in the Nation. ... Geriatrics. #8. in the Nation. ... Neurology & Neurosurgery. #10. in the Nation. ... Obstetrics & Gynecology. #18.

You can now access your Northwestern Medicine patient account multiple ways with MyNM,* powered by MyChart.

Submit the form by: Fax: 312.926. 3093. Email: releaseofinformation@nm.org. Mail: Attn.: Medical Records, 25 North Winfield Road, Winfield, IL 60190.

No matter where you connect with Northwestern Medicine, we're committed to providing access to leading-edge treatments and compassionate care close to where you live and work, with 10 hospitals and more than 200 locations across the Chicago area and Northern Illinois.

Northwestern Medicine Locations Northwestern Memorial Hospital (including Prentice Women's Hospital) Chicago, IL. ... Central DuPage Hospital. Winfield, IL. ... Delnor Hospital. Geneva, IL. ... Huntley Hospital. Huntley, IL. ... Kishwaukee Hospital. DeKalb, IL. ... Lake Forest Hospital. ... Marianjoy Rehabilitation Hospital. ... McHenry Hospital.

If you would like to have your medical records transferred after finishing your program please call the Northwestern Medicine medical records department at 312.695. 8642 to pick up a copy of your records or have a copy of your records sent to your new provider.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232