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Patient Information

Preparing for Your First Clinic Visit

If you are a new patient and scheduled for a visit with one of our providers, you are encouraged to complete the required forms before you arrive. Click on the documents below, print them, complete them, and bring them to your appointment. We look forward to seeing you!

Other Useful Forms

Medical Records Requests

Your medical record is a legal document that keeps track of your health history. You have a legal right to inspect, review, and receive a copy of it. 

Requesting Your Medical Records

To request a copy of your medical record, you need to submit a completed authorization form electronically, by fax, mail, email, or in person. 

How to Submit In-Person

An authorization form may be picked up and/or dropped off at the Kimball Health Services Medical Records Office at 255 W 4th Street in Kimball.

The Medical Records Office is open daily between 7:00 a.m. to 5:00 p.m.

How to Submit by Fax

You can fax a completed authorization form to (308) 235-1955.

How to Submit by Mail

You can mail completed authorization forms to the following address:

Kimball Health Services - Health Information Department
255 W 4th St.

Kimball, NE 59145

How to Submit by Email: 

You can email a completed authorization form to

Please note that if you are unable to encrypt your email, the information on the form will not be secure during the email submission process.

Patient Portal

The Patient Portal of Kimball Health Services is a safe, easy-to-use website where you can access your personal health history, screening results, and important information about your care. It's private, always open, and super simple to use.

Inside the patient portal, you can see who your doctors are, what health problems you've had if you have any allergies, your shots, the medicines you take, results of lab tests done in-house, your vital signs like heart rate and temperature, and reports from any scans you've had. 

You can even download this information to show to other doctors.

How to Set up Your Patient Portal

When you first come to the hospital or clinic, one of our staff will ask for your email address. They'll use this to set up your access to the Patient Portal. 

You'll get an email from us that invites you to log in. If you're treated at our clinics and the hospital, you'll have to make two profiles - one for your clinic records and another for your hospital records. 

If you need any help getting into your Patient Portal or resetting your password, you can email Laura Bateman at

Immunization Records Requests

How you request your immunization records depends on what state you live in. 

For Nebraska immunization records, visit the Nebraska State Immunization System at

For Wyoming immunization records, contact our Pine Bluffs Health Clinic Office and request a copy from the Wyoming Immunization Registry. 

Radiology Imaging & Billing Information

If you need radiology imaging information, it can be obtained directly from our Radiology Department:

Radiology Department
255 W 4th Street
Kimball, NE 69145

Billing information can be accessed from our Billing Office:

Kimball Health Services Billing Office 
255 W 4th Street
Kimball, NE 69145

Keep in mind if you are requesting records or information for someone other than yourself, you are required to provide legal documentation verifying either:

  • Legal guardianship
  • Power of Attorney
  • Executorship
  • Next-of-kin relationship

Care for Veterans

Kimball Health Services is proud to offer care to veterans through the VA Community Care Network. For more information, please visit the How To Get Community Care Referrals And Schedule Appointments page on the Veteran Affairs site. Alternatively, please contact our Patient Accounts Department.

Advanced Directives

An advance directive is a written statement of a person’s wishes regarding medical treatment, often including a living will, that is made to ensure those wishes are carried out should the person be unable to communicate them to a doctor.

You can learn more about Advanced Directives inside of this PDF created by the Nebraska Elder Rights Coalition entitled: The Why, When, and How of Health and Financial Decisions. 

Notice of Privacy Policy

Kimball Health Services is committed to protecting your health information and is required by law to do so under the Health Insurance Portability and Accountability Act (HIPAA). 

The Notice of Privacy Practices describes how we may use and disclose your health information, your privacy rights, and who to contact if you have concerns regarding your health information.

If you have questions about this notice, or have further questions about this notice, or have further questions about how we may use and disclose information about your health information, please contact

Kimball Health Services Privacy Officer – Nancy Prunty
(308) 235-1952, Ext. 162

Hospital Admissions

The Admissions Office is just through the south doors of the hospital. 

When you come to the hospital for care, be sure to bring your most current insurance card and driver’s license or photo ID. Making sure we have complete and accurate patient information begins with the admission process. 

No-Smoking Facility

Kimball Health Services is a smoke-free environment. This supports our commitment to providing a safe and healthy workplace while promoting the health and well-being of our employees and patients. Smoking is not allowed anywhere inside or outside of our facilities.

Language Interpretation

If you speak a language other than English, language assistance and TDD services are available to you free of charge. Please let a staff member know you need language interpretation services, and we will work to accommodate your needs. 

Social Services

Our Social Services Department is available to assist you with any concerns you may have regarding adjustment to illness, hospitalization, or financial concerns related to services at our clinic, specialty clinic, or hospital.

Social Services can also help arrange medical services or assist with other needs that you may require after dismissal from our facility.

Kimball Health Services has a certified Senior Health Insurance Information Program (SHIIP) counselor available for unbiased information on Medicare education and assistance with Medicaid.

For more information about the Nebraska SHIPP program, visit

Western Nebraska Area Resource and Service Directory

Visit to search a list of providers serving western Nebraska.

Memory Care Options

This Memory Care in Nebraska | website provides information on the cost of memory care in Nebraska, financial assistance options for paying for memory care, free memory care resources in the state, and a directory of memory care facilities in Nebraska.

Assisted Living in Nebraska

Visit Assisted Living in Nebraska to learn more about assisted living in Nebraska, including average prices, relevant state regulations, and Medicaid programs that cover these costs.

Nebraska Human Services Online

Visit for local human services information.

Medication Assistance

If you are unable to pay for your medications, pharmaceutical companies may have programs to assist you. We can work with you to identify which programs may be available to you.

Interested or have questions? Contact:

Laura Bateman, RN
(308) 235-1952, Ext. 197

KHS Standard Charges

In an effort to comply with Section 2718(e) of the Affordable Care Act, Kimball Health Services has made standard charges for items and services received in the hospital setting publicly available and in a machine-readable format. 

Pricing for items and services in this file may not always reflect current pricing and is not suitable for the purposes of estimating patient liability.

For patient liability estimates, please contact our Business Office at 308-235-1990.

Download an Excel version of KHS standard charges

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