Montgomery Maryland Ejemplo de carta de solicitud de registros médicos del paciente - Sample Letter for Request for Patient Medical Records

• Category: Cartas - No legales - Médicas
• State: Multi-State
• County: Montgomery
• Control #: US-0328LR
• Format: Word

Description

Carta solicitando registros médicos del paciente. Subject: Request for Patient Medical Records — Montgomery, Maryland Healthcare Center Dear [Healthcare Center's Name], I hope this letter finds you in good health. I am writing to request access to the medical records of [Patient's Full Name], as authorized under the Health Insurance Portability and Accountability Act (HIPAA) and relevant state laws. [Patient's Full Name] has previously been under the care of your esteemed healthcare facility, and I kindly request copies of their medical records for [specific time period or specific medical concern]. Please find the details of [Patient's Full Name] below to assist you in locating the relevant records: — Patient's Full Name— - Date of Birth: - Address at the time of treatment: — Date of Admission/Discharge (if known): — Relevant treating physicians and departments (if known): Additionally, I would like to state that this request is for personal reference and/or for further medical consultation purposes. As the legal representative or family member of [Patient's Full Name], I understand the sensitivity and confidentiality of patient information and ensure its non-disclosure to any unauthorized person. In compliance with state and federal regulations, I am willing to provide any necessary authorization forms or complete any required paperwork to facilitate this request, including an acknowledgment of any associated copying or administrative fees. Please advise on the proper procedure for obtaining these records, including any guidelines, necessary forms, or relevant contact information. Considering the time-sensitive nature of this matter, I kindly request prompt assistance and an estimated timeline for record retrieval. Montgomery, Maryland Sample Letter for Request for Patient Medical Records: 1. General Request for Medical Records: This is a standard letter requesting access to a patient's medical records for personal reference or further medical consultation. 2. Request for Medical Records of Deceased Patient: In cases where the patient has passed away, this letter may be modified to request access to the medical records of a deceased loved one for inheritance claims, legal matters, or research purposes. 3. Request for Medical Records for Legal Proceedings: When medical records are required for legal proceedings, such as personal injury or malpractice lawsuits, this letter can be adapted accordingly to meet legal requirements. 4. Request for Continuity of Care: In the event a patient is moving to a new healthcare provider, this letter can be adjusted to request the transfer of medical records to ensure continuity of care and accurate diagnosis. Please let me know if there are any specific requirements or additional forms necessary to process this request efficiently. I am available at [your contact information] should you require further clarification or information regarding this matter. Thank you for your prompt attention to this request. Your cooperation is greatly appreciated, and I look forward to a timely response. Sincerely, [Your Full Name] [Your Contact Information]

Subject: Request for Patient Medical Records — Montgomery, Maryland Healthcare Center Dear [Healthcare Center's Name], I hope this letter finds you in good health. I am writing to request access to the medical records of [Patient's Full Name], as authorized under the Health Insurance Portability and Accountability Act (HIPAA) and relevant state laws. [Patient's Full Name] has previously been under the care of your esteemed healthcare facility, and I kindly request copies of their medical records for [specific time period or specific medical concern]. Please find the details of [Patient's Full Name] below to assist you in locating the relevant records: — Patient's Full Name— - Date of Birth: - Address at the time of treatment: — Date of Admission/Discharge (if known): — Relevant treating physicians and departments (if known): Additionally, I would like to state that this request is for personal reference and/or for further medical consultation purposes. As the legal representative or family member of [Patient's Full Name], I understand the sensitivity and confidentiality of patient information and ensure its non-disclosure to any unauthorized person. In compliance with state and federal regulations, I am willing to provide any necessary authorization forms or complete any required paperwork to facilitate this request, including an acknowledgment of any associated copying or administrative fees. Please advise on the proper procedure for obtaining these records, including any guidelines, necessary forms, or relevant contact information. Considering the time-sensitive nature of this matter, I kindly request prompt assistance and an estimated timeline for record retrieval. Montgomery, Maryland Sample Letter for Request for Patient Medical Records: 1. General Request for Medical Records: This is a standard letter requesting access to a patient's medical records for personal reference or further medical consultation. 2. Request for Medical Records of Deceased Patient: In cases where the patient has passed away, this letter may be modified to request access to the medical records of a deceased loved one for inheritance claims, legal matters, or research purposes. 3. Request for Medical Records for Legal Proceedings: When medical records are required for legal proceedings, such as personal injury or malpractice lawsuits, this letter can be adapted accordingly to meet legal requirements. 4. Request for Continuity of Care: In the event a patient is moving to a new healthcare provider, this letter can be adjusted to request the transfer of medical records to ensure continuity of care and accurate diagnosis. Please let me know if there are any specific requirements or additional forms necessary to process this request efficiently. I am available at [your contact information] should you require further clarification or information regarding this matter. Thank you for your prompt attention to this request. Your cooperation is greatly appreciated, and I look forward to a timely response. Sincerely, [Your Full 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.