Forms & Instructions for Accessing Care at Howard Brown Health

Want to become a Howard Brown patient? Call us at 773.388.1600.

New Patients

Download the New Patient Packet in English

Download the New Patient Packet in Spanish

Request Medical Records – Release of Information Form in English*

Request Medical Records – Release of Information Form in Spanish*

Read Our Patient and Client Guide

Existing Patients

Request Medical Records – Release of Information Form in English*

Request Medical Records – Release of Information Form in Spanish*

Patient Record Copy Fee Notice

Submit your feedback to HBH using our online incident reporting portal or complete a Client/Patient Complaint and Grievance Form.

*Please be advised there may be a fee associated with records requests. For a patient’s own first request for records, the first fifty (50) pages are free; any request for more than fifty (50) pages incurs a $20.00 charge. Other records requests may incur a charge at a rate set by federal guidelines or Illinois statute.

SIGN UP FOR EMAIL UPDATES

  • This field is for validation purposes and should be left unchanged.
This site is not optimized for Internet Explorer. Please consider viewing the site in a modern browser such as Edge, Chrome or Firefox.