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Medical Records  

insurance If you would like to request your records please contact the Medical Records Department at 708-398-6640 or complete and mail the Medical Release Form. Please select the "Medical Release Form" button below. It can be mailed to 9125 S Pulaski Rd, Evergreen Park, IL 60805.

MEDICAL RECORDS will be shared with another physician at your written request at no charge to you. If you require a copy of your chart, you will be charged $25 for this service. 

medical release form

medical release form


The physicians and staff of Southwest Nephrology Associates, S.C., have always protected the confidentiality of health information. Today, state and federal laws also attempt to ensure the confidentiality of this sensitive information. The federal government publishes regulations designed to protect the privacy of your health information. This "Privacy Rule" protects health information that is maintained by physicians, hospitals, other health providers and health plans. Southwest Nephrology Associates, S.C. has complied with the privacy rule's standards for protecting the confidentiality of your health information. This regulation virtually protects all patients regardless of where they live or where they receive their healthcare. Every time you see a physician or are admitted to the hospital, fill a prescription or send a claim to a health plan, your physician, the hospital and health plan will need to consider the privacy rule. All health information including paper records, oral communications, and electronic formats such as e-mail are also protected by the privacy rule. 

Please let us know if you have any questions about The Notice of Privacy Practices. You may contact our office at 708-398-6627 to discuss any questions or to request a copy of The Notice of Privacy Practices.