Georgia Sample Letter for Request for Medical Records

• Category: Letters - Nonlegal - Requests
• State: Multi-State
• Control #: US-0546LR
• Format: Word; Rich Text

Description

Sample Letter for Request for Medical Records Subject: Request for Medical Records: {Patient Name, Date of Birth, Social Security Number} Dear [Healthcare Provider's Name], I hope this letter finds you well. I am writing to formally request copies of the medical records for {patient's full name}, who was under your care from {start date} to {end date}. As a concerned individual, it is crucial for me to obtain these records to facilitate ongoing healthcare assistance and ensure a seamless transition to new healthcare providers, if needed. To expedite the process, I would appreciate your guidance on the necessary steps and any forms that must be completed to complete this request. Additionally, please inform me of any fees associated with this request and the preferred payment method. {Patient's full name} was receiving treatment at your facility for {type of medical condition or reason for treatment}. Therefore, I kindly request copies of the following medical records: 1. Consultation notes: Comprehensive records of all consultations and evaluations conducted during the period of care. 2. Progress notes: Detailed information on the patient's progress, updates on medications, treatment plans, and any changes made during the treatments. 3. Laboratory reports: Copies of all laboratory tests, including blood tests, urinalysis, and other pertinent diagnostic tests. 4. Radiology records: X-ray, MRI, CT scan reports, or any other relevant imaging investigations performed. 5. Surgical reports, if applicable: Detailed records of any surgeries or procedures performed, including preoperative notes, postoperative progress, and operative reports. 6. Medication records: An updated list of prescribed medications, dosages, frequency, and duration of usage. 7. Therapist and specialist communication notes: Reports from therapists, specialists, or other healthcare professionals involved in the patient's care. 8. Discharge summary: A comprehensive summary outlining the treatment received, post-care instructions, and any referrals or recommendations made. Please notify me of any additional records that may be pertinent to {patient's full name}'s medical history and condition. Due to the urgency of this matter, I kindly request you to process this request as soon as possible. To facilitate a prompt response, I have enclosed a completed and signed authorization form, granting permission for the release of {patient's full name}'s medical records. If there are any additional forms or documentation required, please let me know at your earliest convenience. I would prefer to receive the requested medical records in an electronic format via secure email or a password-protected portal. However, if there are limitations in providing digital copies, please inform me of the available alternative methods for receiving the records. Thank you for your prompt attention to and understanding of this request. If you have any questions or require further information, please do not hesitate to contact me at {your contact information}. I look forward to your positive response and cooperation. Yours sincerely, {Your Name}

Subject: Request for Medical Records: {Patient Name, Date of Birth, Social Security Number} Dear [Healthcare Provider's Name], I hope this letter finds you well. I am writing to formally request copies of the medical records for {patient's full name}, who was under your care from {start date} to {end date}. As a concerned individual, it is crucial for me to obtain these records to facilitate ongoing healthcare assistance and ensure a seamless transition to new healthcare providers, if needed. To expedite the process, I would appreciate your guidance on the necessary steps and any forms that must be completed to complete this request. Additionally, please inform me of any fees associated with this request and the preferred payment method. {Patient's full name} was receiving treatment at your facility for {type of medical condition or reason for treatment}. Therefore, I kindly request copies of the following medical records: 1. Consultation notes: Comprehensive records of all consultations and evaluations conducted during the period of care. 2. Progress notes: Detailed information on the patient's progress, updates on medications, treatment plans, and any changes made during the treatments. 3. Laboratory reports: Copies of all laboratory tests, including blood tests, urinalysis, and other pertinent diagnostic tests. 4. Radiology records: X-ray, MRI, CT scan reports, or any other relevant imaging investigations performed. 5. Surgical reports, if applicable: Detailed records of any surgeries or procedures performed, including preoperative notes, postoperative progress, and operative reports. 6. Medication records: An updated list of prescribed medications, dosages, frequency, and duration of usage. 7. Therapist and specialist communication notes: Reports from therapists, specialists, or other healthcare professionals involved in the patient's care. 8. Discharge summary: A comprehensive summary outlining the treatment received, post-care instructions, and any referrals or recommendations made. Please notify me of any additional records that may be pertinent to {patient's full name}'s medical history and condition. Due to the urgency of this matter, I kindly request you to process this request as soon as possible. To facilitate a prompt response, I have enclosed a completed and signed authorization form, granting permission for the release of {patient's full name}'s medical records. If there are any additional forms or documentation required, please let me know at your earliest convenience. I would prefer to receive the requested medical records in an electronic format via secure email or a password-protected portal. However, if there are limitations in providing digital copies, please inform me of the available alternative methods for receiving the records. Thank you for your prompt attention to and understanding of this request. If you have any questions or require further information, please do not hesitate to contact me at {your contact information}. I look forward to your positive response and cooperation. Yours sincerely, {Your Name}