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Medical Records Request

Instructions

Medical records requests for all former students and alumni can be made through the health office by
completing the request form below. All requests need to be signed by the student, if 18 years old or older, or by a parent/guardian if under 18 years of age. All requests must be accompanied by a driver’s license or photo ID. Records will be processed within 3 to 5 business days.

MedicalRecordRequestForm.pdf

Mail/fax request to:

West Leyden Health Office
1000 N. Wolf Rd
Northlake, IL  60164
Phone: 847-451-3130
Fax: 847-451-5741
East Leyden Health Office
3400 Rose Street
Franklin Park, IL  60131
Phone: 847-451-3084
Fax: 847-451-3085