You can request your records when it's most convenient for you, by using our printable request form.
To obtain copies of your medical records, click here to download and print a request form. Fax or mail the request form to NCH Health Information Management, please allow 24 hours to process Radiology scans to CD. Specific fees apply according to your request.
It is not necessary to make an appointment to pick-up record copies, walk-ins are welcome. For security and privacy, you will be required to show your ID at Patient Services at the time of pick-up.
Mail your printed and completed request form to:
Northwest Community Hospital
Health Information Management Department
800 W. Central Road
Arlington Heights, IL 60005
Fax your printed and completed request form to:
Questions? Call 847.618.3200 (option #1). If you leave a message, a Patient Service Representative will return your call within 24 hours or the next business day.