Labor and Delivery Registration
Use our online delivery registration form to reserve your admission, we recommend that you complete your delivery registration before your seventh month of pregnancy.
Note: You can find your medical registration number on any of your Northwestern Memorial Hospital bills or request it by calling 312-472-3612.
Start the online pre-registration process
I have received service from Northwestern Memorial Hospital or Prentice Women's Hospital in the past and I have a medical record number (this form will take approximately five minutes to complete)
I have not received service at Northwestern Memorial Hospital or Prentice Women's Hospital and do not have a medical record number (this form will take approximately 30 minutes to complete)
Pre-registration Paper Forms
To complete your registration download, print and fill-out the following forms to be faxed.
- About your baby's cord blood (pdf)
- Acknowledgement of Receipt of Notice of Privacy Practice (pdf)
- General Consent and Personal Property and Financial Responsibility (pdf)
- Living Will
- Power of Attorney for Healthcare
- Read About Your Hospital Bill (pdf)
- Read Patient Privacy Statement (pdf)
- Cervical Cytologic Exam (pdf)
Please fax your pre-registration paper forms to the appropriate number below:
If your due date is within the next 90 days
please fax your pre-registration forms to 312-472-0127.
If your due date is greater than 90 days
please fax your pre-registration forms to 312-472-3505.
A Healthy Start
You may download "A Healthy Start" -- a free information card about the benefits of breastfeeding, rooming in, and other practices we encourage in the hospital to help you succeed: