Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with OrthoNebraska before sending sensitive documents. FaxFlow is not affiliated with this organization.

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OrthoNebraska fax number

(402) 609-2174

OrthoNebraska Clinic – Medical Records

Used for: Medical records release / disclosure of medical information (patient requests, insurance/claims, and legal requests).

Fax destination details

Department
OrthoNebraska Clinic – Medical Records
Purpose
Medical records release / disclosure of medical information (patient requests, insurance/claims, and legal requests).
Form
Form 63 (11/21) — Authorization for Disclosure of Medical Information
Address
2725 S. 144th St., Suite 212, Omaha, NE 68144
Voice phone
402-609-2150

Before you send

  • Confirm that this exact department handles your document or request.
  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Complete patient name, date of birth, address, daytime phone; indicate which records to disclose and to whom; specify purpose of disclosure; sign and date; return via the clinic's fax line.

Official form instructions are published as a downloadable file on the organization's website.

Sources and verification

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