Medical Records

How to Obtain Your Hospital or Clinic Medical Records

CHI Health provides you, or your authorized representatives, several options for accessing your health information:

• Request your information from the hospital or clinic where you received care (please see instructions below).
• View portions of your medical information via MyChart.
• Use another application to access your health information.
  • Currently available is the Health app, which is offered by Apple Inc. for iPhones with iOS version software 11.3 or greater. You will recognize it easily by the heart image. The Health app consolidates all of your health data from iPhone, Apple Watch, and third-party apps you already use, so you can view all your progress in one convenient place. This includes your health records from CHI Health and other health systems if you choose to add to add them. To get started:
    • You will need to first set up a portal account with MyChart.
    • The username and password you choose will be the security component for your health information and make it possible for you to access and import it.
    • Please note: we reserve the right to disable a third-party application, if needed. That application’s terms of use will apply and we will not have the control or ability to secure the data you place within that system.

CHI Health Hospitals - Requesting Medical Records

Complete Authorization Form or Patient Access Request Form

Download, print and complete the “Authorization for Use or Disclosure of/Access to Protected Health Information” form (to authorize disclosure of records to another person or organization) or  “Patient Access Request to Their Protected Health Information” form (to request access to own records).  If questions on completing the form, contact the hospital Release of Information representative at the below phone number.

Authorization for Use or Disclosure of/Access to Protected Health Information Form

• Medical Records Request and Authorization
• Autorisation De Divulgation D’informations Du (French)
• Autorización Para Divulgar Información de Registros Médicos (Spanish)
• Giaáy Cho Pheùp Tieát Loä Thoâng Tin Veà Hoà Sô Y Khoa (Vietnamese)
• Ansixinta Diiwaanada Cafimaadka Ee Siideynta Warbixinta (Somali)
• जानकारीको खुलासाका लागि गिककत्सा अगिलेख मञ्जुरीनाम (Nepali)
• သတင်းအချက်အလက် ဖွင့်ဟမှုအတွက်ငှာ ဆေးမှတ်တမ်းများဆိုင်ရာ ထောက်ခံခွင့်ပြုချက် (Burmese)
• တၢ်ဟ့ၣ်စိဟ့ၣ်ကမီၤလၢ တၢ်ကပာ်ဖျါထီၣ် တၢ်ဂ့ၢ်တၢ်ကျိၤလၢ တၢ်ကူစါယါဘျါ တၢ်ကွဲးနီၣအပူၤအဂီၢ် (Karen)

Patient Access Request to Their Protected Health Information Form

• Patient Access Request

Amendment to Protected Health Information

• Patient Request an Amendment to Protected Health Information

Submit the Request

Submit the completed authorization form or access request form to the hospital at which you were treated by mailing or faxing:

CHI Health Creighton University Medical Center - Bergan Mercy
Attn: Health Information Management (Release of Information)
7500 Mercy Rd
Omaha, NE 68124
Phone: (402) 398-6803
Fax: (402) 398-6016

CHI Health Good Samaritan
Attn: Health Information Management (Release of Information)
10 E 31st St
Kearney, NE 68847
Phone: (308) 865-7945
Fax: (308) 865-2926

CHI Health Immanuel
Attn: Health Information Management (Release of Information)
6901 N 72nd St
Omaha, NE 68122
Phone: (402) 572-2097
Fax: (402) 572-2054

CHI Health Lakeside
Attn: Health Information Management (Release of Information)
16901 Lakeside Hills Ct
Omaha, NE 68130
Phone: (402) 717-8041
Fax: (402) 717-8040

CHI Health Mercy Corning
Attn: Health Information Management (Release of Information)
603 Rosary Dr
Corning, IA 50841
Phone: (402) 717-1792
Fax: (402) 717-0032

CHI Health Mercy Council Bluffs
Attn: Health Information Management (Release of Information)
800 Mercy Rd
Council Bluffs, IA 51503
Phone: (712) 328-5924
Fax: (712) 328-5932

CHI Health Midlands
Attn: Health Information Management (Release of Information)
11111 S 84th St
Omaha, NE 68046
Phone: (402) 593-3336
Fax: (402) 593-3353

CHI Health Missouri Valley
Attn: Health Information Management (Release of Information)
631 N 8th St
Missouri Valley, IA 51555
Phone: (402) 717-1792
Fax: (402) 717-0032

CHI Health Nebraska Heart
Attn: Health Information Management (Release of Information)
7500 S 91st St
Lincoln, NE 68526
Phone: (402) 219-7568
Fax: (402) 219-7289

CHI Health Plainview
Attn: Health Information Management (Release of Information)
704 N 3rd St
Plainview, NE 68769
Phone: (402) 717-1792
Fax: (402) 717-0032

CHI Health Schuyler
Attn: Health Information Management (Release of Information)
104 W 17th St
Schuyler, NE 68661
Phone: (402) 717-1792
Fax: (402) 717-0032

CHI Health St. Elizabeth
Attn: Health Information Management (Release of Information)
555 S 70th St
Lincoln, NE 68510
Phone: (402) 219-7731
Fax: (402) 219-7289

CHI Health St. Francis
Attn: Health Information Management (Release of Information)
2620 W Faidley Ave
Grand Island, NE 68803
Phone: (308) 398-5506
Fax: (308) 398-5699

CHI Health St. Mary's
Attn: Health Information Management (Release of Information)
1301 Grundman Blvd
Nebraska City, NE 68410
Phone: (402) 873-8922
Fax: (402) 874-5201

Fees

• There is no charge for records sent directly to a provider or other health care facility for the purpose of continuing care.
• If requesting records for personal or other use, a fee may be charged. Please contact the facility at the above phone number for information.

Processing Your Request

• In most cases, record copies are available in less than a week, however some requests may take longer to process.
• If you have questions or need to verify the status of your submitted request, please contact the facility at the above phone number.

CHI Health Clinics - Requesting Medical Records

• CHI Health Clinic