Dupage medical group medical records 2025

1. Click ‘Get Form’ to open the DuPage Medical Group medical records in the editor.
2. Begin with Section 1: Patient Information. Fill in your first name, last name, date of birth, address, city/state/ZIP, and phone number. Ensure all fields are completed accurately.
3. Move to Section 2: Information Requested. Check all appropriate boxes for the information you need, such as Radiology Reports or Images, and specify the dates of treatment.
4. In Section 3: Authorization, provide the name and contact details of the individual or organization receiving your records.
5. Proceed to Section 4: Method of Delivery. Choose how you would like to receive your records by selecting one option from fax, US mail, or pick up.
6. Complete Section 5: Purpose of Disclosure by checking the relevant reason for requesting your records.
7. Finally, sign and date in Section 6. If applicable, have a representative sign as well. Ensure you understand your rights regarding this authorization.

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