Labor & 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.