Louisiana Ejemplo de carta de solicitud de registros médicos - Sample Letter for Request for Medical Records

• Category: Cartas - No legales - Solicitudes
• State: Multi-State
• Control #: US-0546LR
• Format: Word

Description

Carta de solicitud de registros médicos. Dear [Medical Provider's Name], I hope this letter finds you well. I am writing to request a copy of my medical records in accordance with state and federal laws pertaining to patient access to health information. I have been a patient at your facility and I would like to obtain a complete copy of my medical records for personal reference and continuity of care purposes. As per Louisiana state regulations, specifically the Health Insurance Portability and Accountability Act (HIPAA) laws, patients have the right to access their medical records upon request. Therefore, I kindly request that you provide me with the following documents: 1. A comprehensive copy of all my medical records, including but not limited to: — Physician note— - Consultation reports — Laboratory test result— - Radiology reports (X-rays, MRIs, CT scans, etc.) — Pathology report— - Medication history — Immunization record— - Hospital admission and discharge summaries — Surgical report— - Allergies and medication lists — Any other relevant documents or reports pertaining to my medical history and treatments Please ensure that the records provided cover the entire duration of my involvement with your facility, starting from [Date of First Visit] to the present. If there are any charges associated with obtaining these medical records, kindly inform me in advance. 2. If feasible, I would appreciate it if the records could be provided to me in an electronic format, such as a secure email attachment or CD-ROM, to facilitate easy access and storage. However, if hard copies are the only available option, I am willing to cover any reasonable photocopying and postage fees. In compliance with HIPAA regulations, I understand that there may be certain exceptions to my right of access, such as psychotherapy notes or information that may be deemed harmful. However, I request that you provide a written explanation if any part of my medical records is withheld based on such exceptions. To expedite this process, please find enclosed a completed Authorization for Release of Medical Records form, which includes all the necessary information for identification and record retrieval purposes. If there are any additional forms or steps required, please let me know, and I will promptly provide any requested information. I would appreciate your attention to this matter as soon as possible. Please inform me of any expected timeline or contact me if there are any issues or concerns regarding my request. Your assistance in providing me with access to my medical records will greatly aid in managing my health and ensuring continuity of care. Thank you for your understanding and cooperation. I look forward to your positive response and a prompt resolution to this matter. Sincerely, [Your Name] [Your Contact Information]

Dear [Medical Provider's Name], I hope this letter finds you well. I am writing to request a copy of my medical records in accordance with state and federal laws pertaining to patient access to health information. I have been a patient at your facility and I would like to obtain a complete copy of my medical records for personal reference and continuity of care purposes. As per Louisiana state regulations, specifically the Health Insurance Portability and Accountability Act (HIPAA) laws, patients have the right to access their medical records upon request. Therefore, I kindly request that you provide me with the following documents: 1. A comprehensive copy of all my medical records, including but not limited to: — Physician note— - Consultation reports — Laboratory test result— - Radiology reports (X-rays, MRIs, CT scans, etc.) — Pathology report— - Medication history — Immunization record— - Hospital admission and discharge summaries — Surgical report— - Allergies and medication lists — Any other relevant documents or reports pertaining to my medical history and treatments Please ensure that the records provided cover the entire duration of my involvement with your facility, starting from [Date of First Visit] to the present. If there are any charges associated with obtaining these medical records, kindly inform me in advance. 2. If feasible, I would appreciate it if the records could be provided to me in an electronic format, such as a secure email attachment or CD-ROM, to facilitate easy access and storage. However, if hard copies are the only available option, I am willing to cover any reasonable photocopying and postage fees. In compliance with HIPAA regulations, I understand that there may be certain exceptions to my right of access, such as psychotherapy notes or information that may be deemed harmful. However, I request that you provide a written explanation if any part of my medical records is withheld based on such exceptions. To expedite this process, please find enclosed a completed Authorization for Release of Medical Records form, which includes all the necessary information for identification and record retrieval purposes. If there are any additional forms or steps required, please let me know, and I will promptly provide any requested information. I would appreciate your attention to this matter as soon as possible. Please inform me of any expected timeline or contact me if there are any issues or concerns regarding my request. Your assistance in providing me with access to my medical records will greatly aid in managing my health and ensuring continuity of care. Thank you for your understanding and cooperation. I look forward to your positive response and a prompt resolution to this matter. Sincerely, [Your Name] [Your Contact Information]

Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.