Alegent locations, Medical Records - Omaha, NE; Council Bluffs, IA

HOW TO GIVE | NEWS CENTER | FAITH AT ALEGENT

Start a New Search

Web Chat

Medical Records

Search all Services

Requesting Patient Medical Records:
Admitting or Discharge

What to include with your request for your medical records records:

A Valid Authorization which can be obtained in .pdf format in English, Spanish and French by clicking links on the right side of this page.) Please be sure to include the following:

Patient Name
Date of Birth or Social Security Number for verification
Purpose for which you are requesting records (i.e.- continuing care, personal)
Specify what records you are requesting in as much detail as possible
Address for where you'd like the records to be mailed
Patient signature along with the date of the signature to authorize the release of records

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, to be sent to physician
If you are requesting records for personal use there is .50 cents per page charge for the copies.

How long should the process take? :