Older African American couple looking at paperwork

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.

Electronic Request for Records

Patients can request medical records electronically through the online patient record request tool below.  If questions, contact a release of information representative at (610) 601-8922.

Request records electronically

Request Records by Completion of Authorization Form or Patient Access Request Form

Medical records can be requested by downloading, printing, and completing 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).

Completed paper authorization forms can be submitted via below methods: 

  • Emailed to [email protected]
  • Faxed to 1-800-707-4605
  • Mailed to the address noted below for facility where you received your care

Authorization for use or disclosure of/access to protected health information form

Patient access request to their protected health information form

Submit the completed authorization form or access request form by mail, fax, or email to the hospital at which you received care:

CHI Health Creighton University Medical Center - Bergan Mercy
Attn: Health Information Management (Release of Information)
7500 Mercy Rd
Omaha, NE 68124

CHI Health Good Samaritan
Attn: Health Information Management (Release of Information)
10 E 31st St
Kearney, NE 68847

CHI Health Immanuel
Attn: Health Information Management (Release of Information)
6901 N 72nd St
Omaha, NE 68122

CHI Health Lakeside
Attn: Health Information Management (Release of Information)
16901 Lakeside Hills Ct
Omaha, NE 68130

CHI Health Mercy Corning
Attn: Health Information Management (Release of Information)
603 Rosary Dr
Corning, IA 50841

CHI Health Mercy Council Bluffs
Attn: Health Information Management (Release of Information)
800 Mercy Rd
Council Bluffs, IA 51503

CHI Health Midlands
Attn: Health Information Management (Release of Information)
11111 S 84th St
Omaha, NE 68046

CHI Health Missouri Valley
Attn: Health Information Management (Release of Information)
631 N 8th St
Missouri Valley, IA 51555

CHI Health Nebraska Heart
Attn: Health Information Management (Release of Information)
7500 S 91st St
Lincoln, NE 68526

CHI Health Plainview
Attn: Health Information Management (Release of Information)
704 N 3rd St
Plainview, NE 68769

CHI Health Schuyler
Attn: Health Information Management (Release of Information)
104 W 17th St
Schuyler, NE 68661

CHI Health St. Elizabeth
Attn: Health Information Management (Release of Information)
555 S 70th St
Lincoln, NE 68510

CHI Health St. Francis
Attn: Health Information Management (Release of Information)
2620 W Faidley Ave
Grand Island, NE 68803

CHI Health St. Mary's
Attn: Health Information Management (Release of Information)
1301 Grundman Blvd
Nebraska City, NE 68410

Medical Record Copy Fees

  • For records sent directly to a provider or other health care facility for continuing care, there is no fee.
  • For patients only, a standard fee may be charged.

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 us at the phone number listed above.

CHI Health and CHI Health Clinic have partnered with Datavant and MediCopy services for the release of protected health information (PHI), otherwise known as medical records. Your medical record includes, but is not limited to your medical history, diagnosis, treatment as well as lab results and reports from previous testing and procedures.

To request a copy of your medical records, we ask that you fill out an authorization. You can complete an authorization by following one of the options below. If the patient is a minor, or unable to sign an authorization, the signature of an authorized legal guardian is required. Once your authorization is submitted, please allow two business days before calling to check status.

Request your records online

Fill out an online authorization form. Your authorization will open in your internet browser. If you need to refer back to this page please right click to open in a separate tab. Please note that a valid email address is required when submitting an online authorization and to complete the submission process, you must check your email and verify your request for medical records.

Email your request

Please print an authorization. Once you have filled out your authorization in its entirety, you may securely email it directly to MediCopy at [email protected].

Amendment to protected health information

Submit the completed authorization form or access request form by mail, fax, or email.

Mail your request

Please print an authorization. Once you have filled out your authorization in its entirety, you may mail it directly to MediCopy at:

MediCopy services, Inc.
Attn: Record request – CHI Health clinic
8 City Blvd., Suite 400
Nashville, TN 37209

After MediCopy receives your completed authorization, your request will be processed as quickly as possible and within 30 days as required by law.

Please note that if your records are being mailed, it may take a few additional days for them to arrive. If you have requested to have your records emailed to yourself or another entity, the provided email address will receive a secure, password protected link to your records. For security purposes, this link will expire, so please be sure to check your email regularly, and always check your spam folder!

Is there a charge for the records?

Records sent to another provider are complimentary. There is no charge to have your records emailed or faxed to you. If you request that your medical records be mailed there is a charge for postage and processing.

CHI Health and CHI Health Clinic have partnered with MRO and MediCopy services for the release of protected health information (PHI), otherwise known as medical records. Your medical record includes, but is not limited to your medical history, diagnosis, treatment as well as lab results and reports from previous testing and procedures.

Rural clinics

Iowa

  • CHI Health Bedford Clinic - Bedford, IA
  • CHI Health Corning Clinic - Corning, IA
  • CHI Health Dunlap Clinic - Dunlap, IA
  • CHI Health Lenox Clinic - Lenox, IA
  • CHI Health Logan Clinic - Logan, IA
  • CHI Health Missouri Valley Clinic - Missouri Valley, IA
  • CHI Health Oakland Clinic - Oakland, IA
  • CHI Health Woodbine Clinic - Woodbine, IA

Nebraska

  • CHI Health Clarkson Clinic - Clarkson, NE
  • CHI Health Howells Clinic - Howells, NE
  • CHI Health Plainview Clinic - Plainview, NE
  • CHI Health Schuyler Clinic - Schuyler, NE
  • CHI Health St. Mary's Clinic - Nebraska City, NE

Electronic Request for Records

Patients can request medical records electronically through the online patient record request tool below.  If questions, contact a release of information representative at (610) 601-8922.

Request records electronically

Request records by completion of authorization form or patient access request form

Request your medical records by downloading, printing and completing 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).  Select "Other" and list the clinic from which you are requesting records. 

Authorization for use or disclosure of/access to protected health information form

Patient access request to their protected health information form

Completed paper authorization forms can be submitted via below methods: 

  1. Bring form to the clinic to submit for processing
  2. Mail the form to:
    CHI Health Medical Records
    Attn:  Health Information Management (Release of Information)
    7500 Mercy Rd
    Omaha, NE 68124-2398
  3. Emailed to [email protected]
  4. Faxed to 1-800-707-4605

Medical Record Copy Fees

  • For records sent directly to a provider or other health care facility for continuing care, there is no fee.
  • For patients only, a standard fee may be charged.

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 us at the phone number listed above.