If this is your first time accessing the online payment portal, please contact the registration desk to request your medical record number. If you have any questions or problems with the online payment portal please contact us at (308) 697-3329 or firstname.lastname@example.org
Requesting Copies of Your Medical Records
To request copies of your medical records from Tri Valley Health System you may print the Release of Information form, complete it, and fax it to 308-697-4918 or mail to:
Tri Valley Health System
Health Information Management
PO Box 488
Cambridge, NE 69022
If you have questions or would like a copy of the authorization form mailed to you, please call 308-697-3329 Monday through Friday 8 a.m.-5 p.m. and request the Medical Records Department.
NSAA Physical Evaluation Form
Nebraska School Activities Association (NSAA) Preparticipation Physical Evaluation (Note: This form is to be filled out by the patient and parent prior to seeing the provider.)
Tri Valley Health System's full Notice of Privacy Practices.