Sample Letter Requesting Medical Records

A Letter Requesting Medical Records is a document that can be used by individuals when they would like to request a copy of their records from a medical organization where they have been treated. The purpose of the letter is to officially request a hospital, a practice, a dentist, or any other medical institution to locate an individual's medical records they have, copy them, and send them to the individual.

Alternate Name:

• Medical Record Request Letter.

Generally, individuals use this type of request letter when they want to change their doctor or medical organization. Nevertheless, it can also be done for other reasons - keeping a copy of medical records can help you understand if your health condition changes and you need to do something about it. A sample Letter Requesting Medical Records can be downloaded below.

Your request letter is not supposed to be too long - it only needs three parts. In the first part, you can designate that you are requesting copies of your medical records in accordance with ​​the Health Insurance Portability and Accountability Act (HIPAA) and Department of Health and Human Services regulations. In the second part, you can state the period during which you have been treated in the medical organization. In the final third part, you can ask the receiver to contact you if they are not able to fulfill your request within 30 days.

Still looking for a particular sample? Take a look at the related templates and samples below:

• Sample Patient Discharge Letter;
• Sample Medical Referral Letter;
• Medical Bill Dispute Letter Template.