Patient Forms

Universal Medication Form 
This form allows you to keep one comprehensive list all of your prescriptions, over-the-counter medicines, herbs, supplements oxygen, inhalers and homeopathic remedies in one list. Bring this form with you to your visit to Carroll Hospital or any health care provider, pharmacist or doctor. It will help ensure your health care safety. 

Advance Directives 
An Advance health care directive, also known as living will, personal directive, advance directive or advance decision, are instructions given that specify what actions should be taken for your health care in the event that you are no longer able to make decisions due to illness or incapacity. This form appoints a person to make such decisions on your behalf.

Medical Records
To access your medical records, please print this Authorization for Release of Medical Information, fill it out in its entirety and send to the hospital by mail or fax. The requested medical records will need to be picked up at the hospital and the person receiving the records must show photo identification. 

Mail requests to: 
Carroll Hospital 
Attention: Medical Records Request/HIM 
200 Memorial Avenue Westminster, MD 21157 

Or fax the completed form to 410-871-6867, Attention: Medical Records Request/HIM. 

For more information, please call 410-871-6870.