Request For Medical Records Template

Request For Medical Records To Whom It May Concern:

Medical records contain sensitive and personal information. Check out these free templates that you can use to request your medical records from healthcare providers. I hope this letter finds you in good health. I underwent knee replacement surgery at your hospital, and access to these records is required for my insurance claim and ongoing medical care.

The Medical Record Information Release (Hipaa) Form Allows Patients To Give Authorization To A 3Rd Party And Access Their Health Records.

I am requesting my medical records for reasons related to my health insurance. I have included a signed authorization of medical records release form with this letter. Save time and effort with our free sample letter requesting medical records. I was a patient at your facility from [date of admission] to [date of discharge/last visit].

This Medical Records Request Document Is Used By A Patient To Request That A Healthcare Provider Who Has Treated Them Release Their Medical Records To A Specific Recipient.

Learn how to write an urgent request letter with our free template. Fill out the template online and download it as a pdf or word document. It also allows the added option for healthcare providers to share information. Kindly accept this letter as my formal request to be given copies of my medical records.

I Am Writing To Request A Copy Of My Medical Records From [Hospital/Clinic Name].

Dear [medical records department], i hope this letter finds you well. Need to request your medical records? The purpose of this letter is to request copies of my medical records as allowed by the health insurance portability and accountability act (hipaa) and department of health and human services regulations.