Use our online delivery registration form to reserve your admission - even if you have been a patient or had a previous delivery at Northwestern Memorial in the past.

We recommend that you complete your delivery registration before your seventh month of pregnancy.

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 do not have a medical record number (this form will take approximately thirty minutes to complete)

Download and FAX required forms

• About your baby's cord blood (pdf)   
• Acknowledgement of Receipt of Notice of Privacy Practice (pdf)  
• Read Patient Privacy Statement (pdf)  
• Patient Contact Worksheet (pdf)  
• General Consent and Personal Property and Financial Responsibility (pdf)  
• Read About Your Hospital Bill (pdf)  
• Uterine Cytologic Exam (pdf)  

Pre-Registration Fax Numbers

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.

Important Information

• Advance Directives