The following people have the legal right to sign for release of patient health information:

• The patient
• Parent or legal guardian of a patient up to age 17
  • For patients age 12 to 17, we will not release certain types of information without their consent.
• Guardian appointed by a court*
• Person named as a "health care agent" on a power of attorney for health care form*
• Person named as "attorney-in-fact" in a declaration for mental health treatment*

*Documentation must be provided.

• The executor of the estate*
• The person named as a "health care agent" on a power of attorney for health care form*
• If there is no executor or health care agent, an authorized relative may request records. They must provide:
  • Signed authorized relative certification
  • Certified copy of the death certificate

*Documentation must be provided.

We can provide records in PDF* format through the following electronic methods:

• MyNM patient portal
• Secure email
• On CD

*You will need Adobe Acrobat to read the files. You can download this software online at no cost.

You do not have to pay for records that we send directly to you or to another medical professional.

If you ask us to send your records to someone who is not a medical professional, such as an attorney, we may bill that person.

No. You can only use the online request tool to ask for medical records for yourself or to send to someone else, like a physician who is not at Northwestern Medicine.

To ask for billing records, call 855.694.2866.

To ask for radiology images, go to Request Medical Records or Images. We provide radiology images on a compact disc (CD). We will send the CD by mail, or you can pick it up.

• Fill out all information.
• Write clearly.
• Include information about where you were treated and dates of treatment. A date range is OK.
• If you have an upcoming appointment you need the records for, let us know by filling in the “Requested delivery date.”
• Be specific about what information you want.
  • For medical records, use the “Medical Records to Be Released” section on page 1.
  • For images, use the “Medical Images to Be Released” section on page 2.
  • Use the checkboxes to select the types of information you want.
  • If you want a type of information that is not listed, use the “Other Records – Please Specify” section of the form to list what you are looking for. This might include items like:
    • Immunization records
    • Nursing notes
    • Billing records
    • Pathology slides
    • A copy of your entire medical record
• Be sure to sign and date the form.
  • To request records to be sent to yourself or another health care provider, you can provide an electronic signature.
  • To request records to be sent to someone else, you will need to provide a written signature.
  • You may also need to follow other requirements, such as including a witness signature.

You can pick up records and images at certain Northwestern Medicine hospital locations Monday through Friday, 8:00 am to 4:30 pm.

If you have any questions on pickup locations or the process, please call us at 877.973.2673.

MyNM is an online health management tool. With MyNM, you can:

• Access health information related to your care
• Send secure messages to your physician
• Manage your appointments
• Pay your bills

Please note MyNM contains some, but not all, information from your medical record. Go to nm.org/mychart to find out more about MyNM and sign up. If you would like a staff member to help you sign up for MyNM, call the MyNM team at 855.457.6966.