Forms

Please download, print and complete either of the following forms to release or obtain medical records for the Infectious Disease Center. The requests can be faxed or mailed when completed. Please allow 7-10 business days for the completion of your request.

• Authorization to Obtain Information (pdf)
• Authorization for Release of Information (pdf)

Contact

Infectious Disease Center

251 E Huron, Arkes Pavilion
9th Floor, Suite 940
Chicago, IL 60611
Fax: 312-926-9630

If you have questions, call the Infectious Disease Center at 312-926-8358.