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] Subject: Request for Narrative Medical Report Dear Dr. [Doctor's Last Name], I hope this letter finds you in good health. I am writing to request your assistance in obtaining a narrative medical report for my personal records. As a resident of Louisiana, I understand the importance of having comprehensive documentation of my medical history. I have been under your care for [duration of treatment or relationship], and I truly appreciate the expertise and attention you have provided throughout this time. In order to maintain a thorough understanding of my medical condition, I believe it would be beneficial to have a detailed narrative report that summarizes my health status, medical treatments, and prognosis. The narrative medical report would assist me in various aspects, including but not limited to: 1. Legal and Insurance Purposes: The report will serve as essential documentation for legal proceedings, insurance claims, or disability benefits, ensuring accurate representation of my medical condition and providing a comprehensive overview of my health history. 2. Continuity of Care: The report will serve as a valuable resource for any future healthcare providers I may encounter, ensuring seamless continuity of care. Having access to a comprehensive narrative will aid them in making informed decisions regarding my medical treatments and ongoing care. 3. Personal Health Management: Having a detailed medical report will empower me to take an active role in managing my health effectively. It will allow me to have a better understanding of my medical condition, track progress over time, and enable me to make informed decisions regarding lifestyle modifications, treatment options, and preventive measures. I kindly request that the narrative medical report include the following information: — Detailed medicahistoryor— - Diagnosis(es) and date of diagnosis — Summary of treatments receive— - Medications and dosages prescribed — Results of relevant medical tests, screenings, or diagnostics — Prognosis and anticipated future medical needs — Any significant milestones or changes in my health status Furthermore, I understand that there may be a charge associated with this request, and I am willing to cover any reasonable fees for the preparation and release of the narrative medical report. Please inform me of any associated costs and the preferred method of payment. Should you require any additional information or forms to facilitate this process, please do not hesitate to contact me. I appreciate your attention to this matter and understand that my health records are private and protected by laws, such as the Health Insurance Portability and Accountability Act (HIPAA). Thank you in advance for your understanding and cooperation. I look forward to receiving the narrative medical report as soon as it is convenient for your practice. Your assistance will greatly contribute to the continuity and effectiveness of my overall healthcare management. Yours sincerely, [Your Full Name]
[Your Name] [Your Address] [City, State, Zip Code] [Email Address] [Phone Number] [Date] [Doctor's Name] [Doctor's Address] [City, State, Zip Code] Subject: Request for Narrative Medical Report Dear Dr. [Doctor's Last Name], I hope this letter finds you in good health. I am writing to request your assistance in obtaining a narrative medical report for my personal records. As a resident of Louisiana, I understand the importance of having comprehensive documentation of my medical history. I have been under your care for [duration of treatment or relationship], and I truly appreciate the expertise and attention you have provided throughout this time. In order to maintain a thorough understanding of my medical condition, I believe it would be beneficial to have a detailed narrative report that summarizes my health status, medical treatments, and prognosis. The narrative medical report would assist me in various aspects, including but not limited to: 1. Legal and Insurance Purposes: The report will serve as essential documentation for legal proceedings, insurance claims, or disability benefits, ensuring accurate representation of my medical condition and providing a comprehensive overview of my health history. 2. Continuity of Care: The report will serve as a valuable resource for any future healthcare providers I may encounter, ensuring seamless continuity of care. Having access to a comprehensive narrative will aid them in making informed decisions regarding my medical treatments and ongoing care. 3. Personal Health Management: Having a detailed medical report will empower me to take an active role in managing my health effectively. It will allow me to have a better understanding of my medical condition, track progress over time, and enable me to make informed decisions regarding lifestyle modifications, treatment options, and preventive measures. I kindly request that the narrative medical report include the following information: — Detailed medicahistoryor— - Diagnosis(es) and date of diagnosis — Summary of treatments receive— - Medications and dosages prescribed — Results of relevant medical tests, screenings, or diagnostics — Prognosis and anticipated future medical needs — Any significant milestones or changes in my health status Furthermore, I understand that there may be a charge associated with this request, and I am willing to cover any reasonable fees for the preparation and release of the narrative medical report. Please inform me of any associated costs and the preferred method of payment. Should you require any additional information or forms to facilitate this process, please do not hesitate to contact me. I appreciate your attention to this matter and understand that my health records are private and protected by laws, such as the Health Insurance Portability and Accountability Act (HIPAA). Thank you in advance for your understanding and cooperation. I look forward to receiving the narrative medical report as soon as it is convenient for your practice. Your assistance will greatly contribute to the continuity and effectiveness of my overall healthcare management. Yours sincerely, [Your Full Name]