How to Obtain Your Hospital or Clinic 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) Please mail it to the hospital at which you were treated at the address or fax number listed below.

(For CHI Health Clinic records, please mail or fax the records request form to the clinic location. If you have any questions please call the clinic location.)

CHI Health Creighton University Medical Center - Bergan Mercy
Attn: Release of Information
7500 Mercy Road
Omaha, NE 68124

Phone: 402-398-6803
Fax: 402-398-6016
CHI Health Immanuel
Attn: Release of Information
6901 North 72nd Street
Omaha, NE 68122

Phone: 402-572-2097
Fax: 402-572-2054

CHI Health Midlands
Attn: Release of Information
11111 South 84th Street
Omaha, NE 68046

Phone: 402-593-3336
Fax: 402-593-3353

CHI Health Lakeside
Attn: Release of Information
16901 Lakeside Hills Court
Omaha, NE 68130

Phone: 402-717-8041
Fax: 402-717-8040

CHI Health Mercy Council Bluffs
Attn: Release of Information
800 Mercy Road
Council Bluffs, IA 51503

Phone: 712-328-5924
Fax: 712-328-5932

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.