Colorado Sample Letter to Doctor Requesting Narrative Medical Report

• Category: Letters - Legal - Personal Injury
• State: Multi-State
• Control #: US-0533LTR
• Format: Word; Rich Text

Description

This form is a sample letter in Word format covering the subject matter of the title of the form. [Your Name] [Your Address] [City, State, Zip Code] [Email Address] [Phone Number] [Date] [Doctor's Name] [Doctor's Address] [City, State, Zip Code] Dear Dr. [Doctor's Last Name], Subject: Request for Narrative Medical Report for [Patient’s Full Name], DOB: [Patient’s Date of Birth] I am writing to kindly request your assistance in preparing a narrative medical report for my patient, [Patient's Full Name]. I believe that a detailed narrative report would greatly benefit his/her ongoing medical care and treatment. I have been closely monitoring [Patient’s Full Name]'s medical condition and feel it is crucial to have a comprehensive overview of his/her medical history, including details on previous diagnoses, treatment plans, and any relevant test results. This comprehensive report will assist me in providing the best possible care tailored to his/her specific needs. By obtaining this narrative medical report, I hope to gain a more in-depth understanding of [Patient’s Full Name]'s medical history, including: 1. Past medical conditions and their respective diagnoses, such as allergies, chronic diseases, or genetic disorders, if applicable. 2. Documentation of previous surgeries, treatments, and medications prescribed. 3. Detailed information regarding any complications or ongoing symptoms related to the diagnosed conditions. 4. Relevant test results, such as blood work, X-rays, MRIs, or any other diagnostic or imaging studies performed. 5. An evaluation of the patient's response to previous treatments, including the effectiveness and adverse reactions, if any. Additionally, it would be greatly appreciated if you could include any recommendations or suggestions for future treatment plans, required follow-up appointments, or referrals to appropriate specialists. Please ensure that the report is concise, yet includes all pertinent information for comprehensive patient care. If possible, I kindly request that this narrative medical report be prepared in both hard copy and electronic format for easy reference and safe record keeping. Kindly note that this request is in accordance with the Health Insurance Portability and Accountability Act (HIPAA) guidelines, and I assure you that all information provided will be handled with strict confidentiality. I would be grateful if you could provide this narrative medical report at your earliest convenience. If there are any associated fees for this service, please inform me beforehand so that I can arrange for payment promptly. Thank you for your attention to this matter, and I greatly appreciate your time and expertise in assisting with my patient's care. Sincerely, [Your Full Name] [Your Medical Practice/Organization Name] [Your Medical License Number, if applicable]

[Your Name] [Your Address] [City, State, Zip Code] [Email Address] [Phone Number] [Date] [Doctor's Name] [Doctor's Address] [City, State, Zip Code] Dear Dr. [Doctor's Last Name], Subject: Request for Narrative Medical Report for [Patient’s Full Name], DOB: [Patient’s Date of Birth] I am writing to kindly request your assistance in preparing a narrative medical report for my patient, [Patient's Full Name]. I believe that a detailed narrative report would greatly benefit his/her ongoing medical care and treatment. I have been closely monitoring [Patient’s Full Name]'s medical condition and feel it is crucial to have a comprehensive overview of his/her medical history, including details on previous diagnoses, treatment plans, and any relevant test results. This comprehensive report will assist me in providing the best possible care tailored to his/her specific needs. By obtaining this narrative medical report, I hope to gain a more in-depth understanding of [Patient’s Full Name]'s medical history, including: 1. Past medical conditions and their respective diagnoses, such as allergies, chronic diseases, or genetic disorders, if applicable. 2. Documentation of previous surgeries, treatments, and medications prescribed. 3. Detailed information regarding any complications or ongoing symptoms related to the diagnosed conditions. 4. Relevant test results, such as blood work, X-rays, MRIs, or any other diagnostic or imaging studies performed. 5. An evaluation of the patient's response to previous treatments, including the effectiveness and adverse reactions, if any. Additionally, it would be greatly appreciated if you could include any recommendations or suggestions for future treatment plans, required follow-up appointments, or referrals to appropriate specialists. Please ensure that the report is concise, yet includes all pertinent information for comprehensive patient care. If possible, I kindly request that this narrative medical report be prepared in both hard copy and electronic format for easy reference and safe record keeping. Kindly note that this request is in accordance with the Health Insurance Portability and Accountability Act (HIPAA) guidelines, and I assure you that all information provided will be handled with strict confidentiality. I would be grateful if you could provide this narrative medical report at your earliest convenience. If there are any associated fees for this service, please inform me beforehand so that I can arrange for payment promptly. Thank you for your attention to this matter, and I greatly appreciate your time and expertise in assisting with my patient's care. Sincerely, [Your Full Name] [Your Medical Practice/Organization Name] [Your Medical License Number, if applicable]