Information Prescription

Edward G. Miner Library
Phone: (585)275-2487
Fax: (585)273-1354
Miner_Information@urmc.rochester.edu

Ask a Medical Librarian: Information Prescription	Date: 05/26/2012
Patient Name:	Date of Birth:
Medical Record Number (required)
(Patient type and related information are required) Inpatient	Outpatient
Specify Unit:	Phone Number or E-Mail for Patient/Family Member:
I would like to review the information before it is sent to the patient/family member.
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 Provider Name:	Telephone/Pager Number:
Provider's Division/Community Practice Name:	Attending Physician:

Ask a Medical Librarian: Information Prescription