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

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

Description

Carta de solicitud de registros médicos. Subject: Request for Medical Records — Philadelphia, Pennsylvania Dear [Medical Provider's Name], I hope this letter finds you in good health. I am writing to formally request copies of my medical records from your esteemed institution in Philadelphia, Pennsylvania. As a patient, I believe it is crucial to have access to my complete medical history for personal reference and to facilitate continuity of care. In line with the Health Insurance Portability and Accountability Act (HIPAA) and my rights as a patient, I am entitled to obtain copies of my medical records upon request. To ensure the accuracy and efficiency of this procedure, I kindly request your assistance in providing the following medical records pertaining to my treatment: 1. Diagnostic Reports: I kindly request copies of any diagnostic test results, such as X-rays, MRI, CT scans, ultrasounds, and laboratory reports, conducted during my visits. 2. Consultation Notes: Please provide me with the consultation notes made by the attending physicians during each visit, as these records provide vital insights into my medical condition and treatment plan. 3. Medication Records: In order to have a comprehensive record of my prescribed medications, I request a list of all medications prescribed to me during my visits, including dosage and frequency. 4. Surgical Reports: If any surgeries were performed during my treatment, I would appreciate receiving copies of the surgical reports outlining the procedure, diagnosis, and follow-up care instructions. 5. Immunization Records: If available, please include records of any immunizations or vaccinations administered to me at your facility. 6. Progress Notes: I kindly request copies of progress notes made by healthcare professionals, including nurses and other medical staff, who were involved in my care during each visit. 7. Allergies and Adverse Reaction Records: Please provide a record of any allergies or adverse reactions that have been documented in my medical file for reference and future medical consultations. I would like to receive these documents in an electronic format, preferably via secure email or through a secure online portal provided by your institution. However, if necessary, I am willing to collect the records in person or arrange for a designated person to pick them up on my behalf. To ensure proper identification, I have included the following information: 1. Full Name: [Your Full Name] 2. Date of Birth: [Your Date of Birth] 3. Address: [Your Complete Address] 4. Phone Number: [Your Contact Number] 5. Email Address: [Your Email Address] 6. Patient ID/Account Number: [Your Patient ID/Account Number, if applicable] 7. Dates of Visits: [Specify the approximate dates of your visits, if known] Please provide an estimated timeline for when I can expect to receive the requested medical records. Should there be any associated fees or charges for this service, kindly inform me in advance. I greatly appreciate your attention to this matter and your cooperation in providing me with my medical records. Thank you for your dedication in preserving patient rights and ensuring seamless healthcare delivery in Philadelphia, Pennsylvania. Yours sincerely, [Your Name]

Subject: Request for Medical Records — Philadelphia, Pennsylvania Dear [Medical Provider's Name], I hope this letter finds you in good health. I am writing to formally request copies of my medical records from your esteemed institution in Philadelphia, Pennsylvania. As a patient, I believe it is crucial to have access to my complete medical history for personal reference and to facilitate continuity of care. In line with the Health Insurance Portability and Accountability Act (HIPAA) and my rights as a patient, I am entitled to obtain copies of my medical records upon request. To ensure the accuracy and efficiency of this procedure, I kindly request your assistance in providing the following medical records pertaining to my treatment: 1. Diagnostic Reports: I kindly request copies of any diagnostic test results, such as X-rays, MRI, CT scans, ultrasounds, and laboratory reports, conducted during my visits. 2. Consultation Notes: Please provide me with the consultation notes made by the attending physicians during each visit, as these records provide vital insights into my medical condition and treatment plan. 3. Medication Records: In order to have a comprehensive record of my prescribed medications, I request a list of all medications prescribed to me during my visits, including dosage and frequency. 4. Surgical Reports: If any surgeries were performed during my treatment, I would appreciate receiving copies of the surgical reports outlining the procedure, diagnosis, and follow-up care instructions. 5. Immunization Records: If available, please include records of any immunizations or vaccinations administered to me at your facility. 6. Progress Notes: I kindly request copies of progress notes made by healthcare professionals, including nurses and other medical staff, who were involved in my care during each visit. 7. Allergies and Adverse Reaction Records: Please provide a record of any allergies or adverse reactions that have been documented in my medical file for reference and future medical consultations. I would like to receive these documents in an electronic format, preferably via secure email or through a secure online portal provided by your institution. However, if necessary, I am willing to collect the records in person or arrange for a designated person to pick them up on my behalf. To ensure proper identification, I have included the following information: 1. Full Name: [Your Full Name] 2. Date of Birth: [Your Date of Birth] 3. Address: [Your Complete Address] 4. Phone Number: [Your Contact Number] 5. Email Address: [Your Email Address] 6. Patient ID/Account Number: [Your Patient ID/Account Number, if applicable] 7. Dates of Visits: [Specify the approximate dates of your visits, if known] Please provide an estimated timeline for when I can expect to receive the requested medical records. Should there be any associated fees or charges for this service, kindly inform me in advance. I greatly appreciate your attention to this matter and your cooperation in providing me with my medical records. Thank you for your dedication in preserving patient rights and ensuring seamless healthcare delivery in Philadelphia, Pennsylvania. Yours sincerely, [Your Name]

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.