Forms


We value your privacy, so please never submit your medical records to our practice via email. Email is not secure or HIPPAA protected, and we want to ensure that your patient information remains private.

Existing patients: Please fax your medical records to our practice at 708.848.0008. Feel free to call our office at 708.848.3800 to verify that the records were received.

Prospective patients: Please log in to our Athena Portal, create an account, and request a consultation. Once you’ve requested your appointment, please fax us your medical records at 708.848.0008. We remind you to please not use email, as it is not secure or HIPPAA protected. 


Download Forms

Release of Medical Records
From current provider to West Suburban Midwife Associates

Release of Medical Records
From West Suburban Midwife Associates to new provider

Insurance Verification
See Billing for instructions and additional information.