[Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] [Recipient's Name] [Healthcare Facility Name] [Facility Address] [City, State, ZIP Code] Subject: Request for Medical Records Dear [Recipient's Name], I hope this letter finds you well. I am writing to request copies of my medical records in accordance with my rights under the Health Insurance Portability and Accountability Act (HIPAA) and the New Mexico State law. I have been a patient at your facility and would like to obtain a comprehensive set of my medical records for personal reference and continuity of care. To facilitate the process, I have provided the necessary information below: Patient Information: — Full Name: [Your Full Name— - Date of Birth: [Your Date of Birth] — Medical Record Number (if known): [If Applicable] Records Requested: Please provide copies of the following medical records pertaining to my care: 1. Inpatient records 2. Outpatient records 3. Consultation records from specialists 4. Laboratory test results 5. Radiology reports 6. Surgical records 7. Immunization records 8. Pathology reports 9. Progress notes 10. Medication history and prescriptions 11. Allergies and adverse reactions 12. Discharge summaries 13. Any additional relevant medical documentation Authorization: In compliance with HIPAA regulations and New Mexico State law, I am enclosing a signed HIPAA release form with this letter. This form authorizes the release of my medical records to me or my designated representative. Preferred Format and Delivery Method: Please provide the requested records in a paper format. If digital copies are available, such as a PDF file, I would greatly appreciate receiving them electronically via email at [Your Email Address]. If this is not feasible, kindly inform me of the available alternative methods of delivery. Fees and Processing Time: I am aware that a reasonable fee may apply for this service as permitted by law. Please inform me in advance of any applicable charges, and I will promptly submit the necessary payment. Additionally, I kindly request an estimated timeline for the completion of the record retrieval process. If you have any questions or require further information, please do not hesitate to contact me at [Your Phone Number] or via email at [Your Email Address]. I would greatly appreciate your prompt attention to this matter, as I am in need of these records for personal health management purposes. Thank you for your time and assistance. I look forward to a positive response and a smooth process. Sincerely, [Your Full Name]
New Mexico Sample Letter for Request for Medical Records
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How to fill out New Mexico Sample Letter For Request For Medical Records?
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Our Vital Records Call Center is also available from a.m. to p.m. to answer your questions at 1-866-534-0051 or 505-827-0121. We only issue certificates for individuals who were born in the state of New Mexico.
New Mexico statute requires that medical records for Medicaid patients must be kept for at least six years from the date of creation of the record. NMSA 1978 § 27-11-4 A. (2016). Hospital records, regardless of the insurer, must be retained for ten years.
Most practices or facilities will ask you to fill out a form to request your medical records. This request form can usually be collected at the office or delivered by fax, postal service, or email. If the office doesn't have a form, you can write a letter to make your request.
If the patient wrote a personal letter requesting records, make sure the following patient information was in the original request:Date of birth.Name.Social Security number.Contact information (address and phone number)Email address.Dates of service and specific records requested (tests, discharge notes, etc.)More items...
The subject line of your request should be "FOIL Request". Please inform me of the cost of providing paper copies of the following records include as much detail about the records as possible, including relevant dates, names, descriptions, etc..
What information should be included in a patient's medical records?The initial health history and physical examination from the doctor.Consultation reports from specialists, as well as any notes.Operative reports / Medical procedure reports.More items...?
In accordance with HIPAA regulations, you may request copies of your medical records for personal use. Contact our medical records office at 505-925-0106 for more information.
The short answer is most likely five to ten years after a patient's last treatment, last discharge or death. That being said, laws vary by state, and the minimum amount of time records are kept isn't uniform across the board.
How to Request Your Medical Records. Most practices or facilities will ask you to fill out a form to request your medical records. This request form can usually be collected at the office or delivered by fax, postal service, or email. If the office doesn't have a form, you can write a letter to make your request.
