How to Obtain Your Medical Records
1) Download, print and complete the “Request and Authorization” form. You also may request the form by calling the hospital at which you were treated.
2) Mail or Fax it to the hospital at which you were treated at the address or fax number listed below:
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Bergan Mercy Medical Center
Attn: Release of Information
7500 Mercy Road
Omaha, NE 68124
Phone: 402-398-6803
Fax: 402-398-6016
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Creighton University Medical Center
Attn: Release of Information
601 N. 30th St.
Omaha, NE 68131
Phone: 402-449-4355
Fax: 402-449-4725 |
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Immanuel Medical Center
Attn: Release of Information
6901 North 72nd Street
Omaha, NE 68122
Phone: 402-572-2097
Fax: 402-572-2054
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Lakeside Hospital
Attn: Release of Information
16901 Lakeside Hills Court
Omaha, NE 68130
Phone: 402-717-8041
Fax: 402-717-8040
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Mercy Hospital
Attn: Release of Information
800 Mercy Road
Council Bluffs, IA 51503
Phone: 712-328-5924
Fax: 712-328-5932 |
Midlands Hospital
Attn: Release of Information
11111 South 84th Street
Omaha, NE 68046
Fhone: 402-593-3336
Fax: 402-593-3353 |
If you would like to personally pick up your records
- Specify on your request that you would like to pick up your records
- Be sure to provide a contact phone number where we can reach you
- If records are needed by a specific date, please specify that on your request
- A valid driver’s license or other form of picture identification is required to pick up copies of your records.
There may be a charge for your records
- There is no charge for records if you need them for continuation of care
- If you are requesting records for personal use there is .50 cents per page charge for the copies.
How long should the process take?
- In most cases record copies are available in less than a week.
- Some requests take longer to process. If you have questions you may call the number above to verify the status of your request.
