URMC / Libraries / Basil G. Bibby Library / Ask A Librarian / Get Information For Your Patients

Get Information For Your Patients

Use this form to request reliable and appropriate healthcare information for your patients and their families. Available to URMC clinicians, social workers and staff.

Searches are returned within 1 week.

Fields marked with an * are required.

Patient Information

*Patient Name:

*Date of Birth:

*Medical Record Number:

Specify if Inpatient or Outpatient

*Specify Unit:

Review Preference

I would like to review the information before it is sent to the patient/family member.

Search Request Information

*Describe Information Request:

Include background information about condition/any complicating factors that should be considered in the information retrieval (include patient's age; no acronyms please).

Healthcare Team Information

*Healthcare Provider Name:

*Phone/Pager Number:

*Provider's Division/Community Practice Name:

*Attending Physician: