Patient Information

Patient Forms

For your convenience, a number of forms are available here for download.

Advanced directives

An advance directive is a written statement that documents your healthcare decisions or appoints another person to make decisions on your behalf. Advance directives include Living Wills and Durable Power Attorney for Health Care.

Power of Attorney
Living Will

Health Information Access

Patients and their legal representatives generally have a right to their medical records. All you need to do is make a written request and pay a fee.

Request to Inspect or Copy Health Information
Authorization for Release of Information

Organ Donation

Organ and tissue donation after your death can play a vital role in improving the quality of life for others. Use the following link to register with the Nebraska Organ Recovery System.
https://www.donoregistry.org/ne/

Privacy Policy

The confidentiality and security of your health information is our first priority.

As a patient of Harlan County Health System, you can count on us to keep your health private and secure from any unauthorized access.