Patient Result Requests


It is best for patients to reach out to their provider directly to obtain test results. If you would like to obtain a copy of your Results from Regional Pathology Services please follow the below guidelines.

The following people are authorized to sign for release of information:

  • The patient (Not the spouse)

  • Power of attorney, if patient is unable to sign (Document must be provided)

  • Parent (If the patient is under the age of 19)

  • Legal Guardian (Proof of guardianship document must be provided)

  • Representative of the estate for deceased patients (Copy of death certificate and a copy of the representative of estate documents must be provided) 

Completing the Authorization Form:

1. Print the following information: Patient name, date of birth, street address, city, state, zip code and phone number.

2. Check the appropriate box(es) that corresponds with the results that are being requested.

3. Write the date(s) of service or time frame for which you are requesting records (i.e. physician office visit 01/25/08 or all records from 2007-2008).

4. Write the name and address of the person to whom records will be released.  If you want the results to be sent to yourself, please write your personal contact information in this section.

5. How would you like your results delivered?

  • Please indicate whether you would like your results mailed, faxed or picked up at one of our two facilities.

  • If someone other than the patient will pick up the records, write the responsible person(s) name on the bottom of the release of medical record form. You will be asked to present a photo ID when picking up medical records.

6. The form may be mailed, faxed or brought into one of our facilities. Please allow 12 business days for results to be available for pick up or mailed/faxed.

7. When picking results up in person, you MUST bring a government issued photo ID.

  • The University of Nebraska Medical Center, 42nd & Emile, 1st Floor Diagnostic Center; Omaha, NE  68198 (let staff know you are there for Regional Pathology Services).

  • Oakview Medical Building, 2727 So 144th Street, Suite 160, 1st Floor, Laboratory; Omaha, NE  68144

8. Office hours are 8:00 a.m. to 5:00 p.m., Monday through Friday.  The completed form may be mailed or faxed to the laboratory – signatures must be notarized, and include a copy of a photo ID if the  form is mailed or faxed.   

If you have questions about completing this form, please call 402-559-6420 or 1-800-334-0459. **Note: Expect to receive results within 30 days of receipt of form.** 

Mailing Address

Regional Pathology Services

981180 Nebraska Medical Center

Omaha, NE 68198

Fax: 402-559-9497

Release of Medical Record Authorization Form