Request Your Medical Records
When a patient needs a copy of his or her medical record, our Health Information Management department is available to help. The department is open Monday through Friday from 8 a.m. to 4:30 p.m. The Release of Information office is located on the third floor of the main hospital in room 3380.
Request for Access to Protected Health Information
Please complete the Request for Access to Protected Health Information form to have a copy of your medical records sent to you.
Authorization for Release of Information
For Fremont Health to release medical records to anyone other than an individual patient, the patient must complete the Authorization for Release of Information form.
Authorization for Proxy Access to Fremont Health's Patient Portal
For access to another person's medical records other than your own, you will be required to complete the Proxy Access Form.
Completed forms may be returned in person, by mail, or fax to:
Fremont Health Medical Center
Health Information Management
450 E 23rd St
Fremont, NE 68025
Fax: (402) 727-3514
Court Order and subpoena requests for medical records may be delivered to the Health Information Management Department Release of Information office at the Fremont Health Medical Center between the hours of 8 a.m. and 4:30 p.m., Monday through Friday or via certified mail. If you have any questions about a court order or subpoena requests for medical records, please call (402) 727-3434.