Regional West Medical Center
Health Information Department (HIM)
(308) 630-1346

To receive a copy of your medical record from Regional West Medical Center, you must complete and sign an “Authorization for Use & Disclosure of Protected Health Information” form. To obtain the form, click here or contact the Health Information Management (Medical Records) Department at (308) 630-1194.

Please complete each section of the form and include your signature and date. Unsigned or incomplete forms will be returned.

Please send the completed form to:
Regional West Medical Center
HIM Department
Attention: ROI Specialist
4021 Avenue B
Scottsbluff, NE 69361
Or fax to: (308) 630-1094

According to the Health Information Portability & Accountability Act (HIPAA) Regional West is allowed 30 days to complete your request. However, Regional West strives to process all requests within five to seven business days. You may pick up your records between 7 a.m. and 5 p.m. Monday through Friday or 7 a.m. to 2:30 p.m. on weekends. Please bring photo identification with you. If someone will be picking up the records for you, they must have written permission from you and also provide photo identification.

If you prefer, we will mail your records to the address you list on the Authorization for Use & Disclosure of Protected Health Information form.

Please contact Regional West Health Information Department at (308) 630-1346 or (308) 630-1194 if you need assistance.