Patient Forms | MedStar NRH | MedStar Health
MedStar National Rehabilitation Hospital, Washington DC

Patient forms

The MedStar National Rehabilitation Network (MedStar NRH) is a regional system of rehabilitation care that offers inpatient, day treatment, and outpatient services in Washington, D.C., Maryland, and Northern Virginia.

Here are some documents and forms you may need to reference during your treatment at MedStar National Rehabilitation Hospital.

Outpatient Registration Form

Medicare Eligibility Form (for Medicare patients only)

Patient Forms for Physician Services - Physician Visit Outpatient Health History form

Medical records

All patient healthcare information at MedStar National Rehabilitation Hospital is confidential. Therefore, medical records cannot be released to any person without the authorization of the patient or the patient's legally authorized representative (unless authorized by law).

To request the release of your medical information, fill out our Medical Records Release Form.

Forms can be mailed to: 
MedStar National Rehabilitation Hospital
102 Irving St. NW
Washington, DC, 20010

For more information, call 202-877-1180, ask for fax

Portable health profile

It’s important that you know and keep track of changes in your own health information. Because people see many different healthcare providers, this can be difficult to do. Using a portable health profile (PHP) can make keeping track of your health information easier. When you give healthcare providers the right information, you help them take better care of you. An example of a PHP has been provided for you. We suggest you write in pencil so you can update the PHP as things change. You can also find similar PHPs at:

  • my PHR, American Health Information Management Association

  • Your Family Member’s Personal Health Record, Next Step in Care

  • Our MedStar National Rehabilitation Hospital website: Portable Health Profile (PHP) Data Collection Form

Please let us know if you need any help updating your PHP with the new information from your stay at MedStar National Rehabilitation Hospital.

To download the Portable Health Profile Information PDF, please click here

Support groups

There are a number of local support groups for persons with disabilities and their families. All are welcome to participate. These groups serve as a gathering place offering peer-to-peer support and advice in dealing with the daily challenges of living with a disability. They are an opportunity to learn from the experience of others, who once had the same questions as you, and for others to learn from your experience.

Patient portal

Current patients can email their MedStar Health physician, request prescription renewals, appointments, medical records, and referrals.

Login to myMedStar

If you are a new patient, register to get started with myMedStar Patient Portal.

Enroll now