Hawaii 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. Subject: Request for Narrative Medical Report — Hawaii Sample Letter to Doctor Dear [Doctor's Name], I hope this letter finds you well. My name is [Your Name] and I am writing to kindly request your assistance in preparing a narrative medical report regarding my health condition for legal purposes. I have been advised that having a comprehensive medical report will greatly contribute to my case. As a patient in the state of Hawaii, I understand that you might be required to structure the report in a specific manner to comply with local requirements. I would appreciate it if you could provide me with a detailed narrative medical report that encompasses the following essential elements: 1. Personal Information: — Full name, datbirthtAlanaaddresseeses— - Contact details (phone number, email) 2. Medical History: — A chronological summary of my medical history, including relevant surgeries, illnesses, or injuries. — An overview of any pre-existing conditions that might affect my current health status. — If applicable, the impact of lifestyle factors such as smoking, alcohol consumption, or obesity. 3. Current Health Condition: — Description of the current health issue, its onset, and progression. — Any symptoms experienced, their intensity, duration, and frequency. — Examination findings, including vital signs, test results, and imaging studies. 4. Treatment Details: — Detailed information about all prescribed medications, dosages, and frequency. — Past and ongoing treatments, including surgical procedures, medical therapies, or rehabilitation programs. — Adverse reactions to any medications or treatments. 5. Functional Limitations: — Any physical or cognitive limitations caused by the medical condition. — Impact on daily activities, including self-care, work, hobbies, and social interactions. — Duration and prognosis of these limitations. 6. Specialist Consultations: — Summary of any consultations with other healthcare professionals. — Opinion or recommendations provided by specialists in relevant fields. I kindly request that you use concise, clear, and non-technical language while preparing the narrative medical report. It should be comprehensive enough to provide an accurate understanding of my health condition and its potential effects, while also supporting the legal requirements of my case. Once the report is complete, I would appreciate it if you could send it to me in both hard copy and electronic format, either via email ([Your Email Address]) or by postal mail to the following address: [Your Postal Address]. Thank you for your valuable time and attention to this matter. If you have any questions or need any further information, please do not hesitate to contact me directly. Your support in this process is greatly appreciated. Sincerely, [Your Name] [Your Contact Information]

Subject: Request for Narrative Medical Report — Hawaii Sample Letter to Doctor Dear [Doctor's Name], I hope this letter finds you well. My name is [Your Name] and I am writing to kindly request your assistance in preparing a narrative medical report regarding my health condition for legal purposes. I have been advised that having a comprehensive medical report will greatly contribute to my case. As a patient in the state of Hawaii, I understand that you might be required to structure the report in a specific manner to comply with local requirements. I would appreciate it if you could provide me with a detailed narrative medical report that encompasses the following essential elements: 1. Personal Information: — Full name, datbirthtAlanaaddresseeses— - Contact details (phone number, email) 2. Medical History: — A chronological summary of my medical history, including relevant surgeries, illnesses, or injuries. — An overview of any pre-existing conditions that might affect my current health status. — If applicable, the impact of lifestyle factors such as smoking, alcohol consumption, or obesity. 3. Current Health Condition: — Description of the current health issue, its onset, and progression. — Any symptoms experienced, their intensity, duration, and frequency. — Examination findings, including vital signs, test results, and imaging studies. 4. Treatment Details: — Detailed information about all prescribed medications, dosages, and frequency. — Past and ongoing treatments, including surgical procedures, medical therapies, or rehabilitation programs. — Adverse reactions to any medications or treatments. 5. Functional Limitations: — Any physical or cognitive limitations caused by the medical condition. — Impact on daily activities, including self-care, work, hobbies, and social interactions. — Duration and prognosis of these limitations. 6. Specialist Consultations: — Summary of any consultations with other healthcare professionals. — Opinion or recommendations provided by specialists in relevant fields. I kindly request that you use concise, clear, and non-technical language while preparing the narrative medical report. It should be comprehensive enough to provide an accurate understanding of my health condition and its potential effects, while also supporting the legal requirements of my case. Once the report is complete, I would appreciate it if you could send it to me in both hard copy and electronic format, either via email ([Your Email Address]) or by postal mail to the following address: [Your Postal Address]. Thank you for your valuable time and attention to this matter. If you have any questions or need any further information, please do not hesitate to contact me directly. Your support in this process is greatly appreciated. Sincerely, [Your Name] [Your Contact Information]