Record Services 

SERVING THE LEGAL AND CORPORATE COMMUNITIES SINCE 1960


EXPERIENCE • QUALITY • DEPENDABILITY

312.726.6650  requestil@rcsorder.com

FORMS

 

AUTHORIZATION FORMS (PDF Format)

Advocate Hospitals
Advocate Lutheran General Hospital
Alexian Brothers Behavioral Health
Blue Cross Illinois 
Chicago EMS Ambulance Charges
Chicago Fire Dept EMS 
IL Dept of Children and Family Services (ICFS)
IL Dept of Corrections - Mental Health/Substance
IL Dept of Corrections - Medical Health
IL Dept of Healthcare and Family Svcs (Public Aid)
IL Dept of Human Services (IDHS)
IL Dept of Revenue - IL 4506
IRS - Form 4506
Mayo Clinic
Medicare
Military HIPAA

National Personnel Record Center (NPRC)
Social Security Administration (SSA)
Veterans Affairs
Walgreens

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