Prentice Pre-registration Forms
Pre-Registration Paper Forms
The hospital requires your signed consent or acknowledgement on several forms. Some are required under Federal and State laws. Some are required by the hospital as part of the admission process. If you have any questions about these forms, please call the Prentice Admitting Offices at (312) 472-3599.
(Adobe Acrobat Reader is needed to download form)
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)
Advance Directives Information
Advance Directives
- Download a Living Will form: English, Spanish (pdf)
- Download a Power of Attorney form: English, Spanish (pdf)
- Download a Mental Health Treatment Preference Declaration (pdf)
