Phoenix Arizona Sample Letter for Request for Medical Records

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

Description

Sample Letter for Request for Medical Records Subject: Inquiry for Phoenix, Arizona Sample Letter for Requesting Medical Records Dear [Healthcare Provider's Name], I hope this message finds you well. I am writing to request access to my medical records as per my rights under the Health Insurance Portability and Accountability Act (HIPAA) and applicable state laws. I received care at your esteemed medical facility in Phoenix, Arizona, and I would greatly appreciate your assistance in obtaining these records for my personal reference and continued care. Furthermore, I kindly request a copy of my complete medical records, including all pertinent information such as diagnosis, treatment plans, progress notes, laboratory test results, and any other relevant documentation associated with my healthcare history. In addition, if available, please also provide any imaging reports, referrals, consultation notes, and discharge summaries. To facilitate the process, I have provided my relevant details below: Full Name: [Your Full Name] Date of Birth: [Your Date of Birth] Patient ID/Account Number: [If Applicable] Dates of Treatment: [Date ranges or specific dates if known] Is there is any applicable fee associated with obtaining these records, please inform me in advance. I understand that there may be reasonable costs related to copying and postage, and I will gladly cover these expenses upon your prompt notification. Moreover, I would appreciate your guidance on the preferred method of delivery for these records. Whether it be via secure email, regular mail to the address listed in my records, or if there is an online patient portal available, kindly advise me on the most suitable option. While I understand the process might take some time, I kindly request your prompt attention to this matter. Should you require any further details or have any questions regarding my request, please do not hesitate to reach out to me at [Your Contact Number] or [Your Email Address]. Thank you for your attention and cooperation in facilitating this process. I greatly appreciate your assistance in providing me with access to my medical records as permitted by law. Sincerely, [Your Full Name] [Your Address] [City, State, ZIP Code]

Subject: Inquiry for Phoenix, Arizona Sample Letter for Requesting Medical Records Dear [Healthcare Provider's Name], I hope this message finds you well. I am writing to request access to my medical records as per my rights under the Health Insurance Portability and Accountability Act (HIPAA) and applicable state laws. I received care at your esteemed medical facility in Phoenix, Arizona, and I would greatly appreciate your assistance in obtaining these records for my personal reference and continued care. Furthermore, I kindly request a copy of my complete medical records, including all pertinent information such as diagnosis, treatment plans, progress notes, laboratory test results, and any other relevant documentation associated with my healthcare history. In addition, if available, please also provide any imaging reports, referrals, consultation notes, and discharge summaries. To facilitate the process, I have provided my relevant details below: Full Name: [Your Full Name] Date of Birth: [Your Date of Birth] Patient ID/Account Number: [If Applicable] Dates of Treatment: [Date ranges or specific dates if known] Is there is any applicable fee associated with obtaining these records, please inform me in advance. I understand that there may be reasonable costs related to copying and postage, and I will gladly cover these expenses upon your prompt notification. Moreover, I would appreciate your guidance on the preferred method of delivery for these records. Whether it be via secure email, regular mail to the address listed in my records, or if there is an online patient portal available, kindly advise me on the most suitable option. While I understand the process might take some time, I kindly request your prompt attention to this matter. Should you require any further details or have any questions regarding my request, please do not hesitate to reach out to me at [Your Contact Number] or [Your Email Address]. Thank you for your attention and cooperation in facilitating this process. I greatly appreciate your assistance in providing me with access to my medical records as permitted by law. Sincerely, [Your Full Name] [Your Address] [City, State, ZIP Code]