San Bernardino California Sample Letter for Request for Medical Records

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

Description

Sample Letter for Request for Medical Records Subject: Request for Medical Records — San Bernardino, California Dear [Healthcare Provider/Hospital/Physician's Office], I hope this letter finds you well. I am writing to request copies of my medical records from [insert specific dates or a period, if applicable], as I am relocating to a new city and require them for continued medical care. As a resident of San Bernardino, California, I understand the importance of having my medical records readily available for any future healthcare needs. With this in mind, I kindly ask for your assistance in facilitating the transfer of my records to the new healthcare provider in my new location. The requested records are necessary to ensure seamless and uninterrupted medical care during this transition. The specific medical records I am requesting include, but are not limited to, the following: 1. Laboratory results: Please provide copies of all blood tests, urine tests, radiology reports, and any other diagnostic tests conducted during the specified period. 2. Prescription records: Kindly include a list of all medications prescribed along with the dosage, frequency, and duration for each medication. 3. Consultation and specialist reports: If any referrals were made to specialists or if I had any consultations during the specified period, I request copies of these reports. 4. Surgical records: Please include operative notes and any PRE or post-operative records, if applicable. 5. Immunization records: If available, I would appreciate a copy of my immunization records for continuity of care. Please ensure that all sensitive personal information, such as Social Security numbers or financial information, is safely redacted or protected in accordance with the applicable privacy laws. I understand that there might be a fee associated with obtaining these records, and I am more than willing to cover any reasonable costs. Please inform me (via the contact information provided) of the applicable fees and the preferred method of payment. Given the urgency of this matter, I kindly request that you process my request as soon as possible. Should you have any questions or require additional information to fulfill this request, please do not hesitate to contact me. Thank you for your prompt attention to this matter. I truly appreciate your ongoing commitment to providing quality healthcare services to your patients. Sincerely, [Your Full Name] [Your Contact Information] [Date]

Subject: Request for Medical Records — San Bernardino, California Dear [Healthcare Provider/Hospital/Physician's Office], I hope this letter finds you well. I am writing to request copies of my medical records from [insert specific dates or a period, if applicable], as I am relocating to a new city and require them for continued medical care. As a resident of San Bernardino, California, I understand the importance of having my medical records readily available for any future healthcare needs. With this in mind, I kindly ask for your assistance in facilitating the transfer of my records to the new healthcare provider in my new location. The requested records are necessary to ensure seamless and uninterrupted medical care during this transition. The specific medical records I am requesting include, but are not limited to, the following: 1. Laboratory results: Please provide copies of all blood tests, urine tests, radiology reports, and any other diagnostic tests conducted during the specified period. 2. Prescription records: Kindly include a list of all medications prescribed along with the dosage, frequency, and duration for each medication. 3. Consultation and specialist reports: If any referrals were made to specialists or if I had any consultations during the specified period, I request copies of these reports. 4. Surgical records: Please include operative notes and any PRE or post-operative records, if applicable. 5. Immunization records: If available, I would appreciate a copy of my immunization records for continuity of care. Please ensure that all sensitive personal information, such as Social Security numbers or financial information, is safely redacted or protected in accordance with the applicable privacy laws. I understand that there might be a fee associated with obtaining these records, and I am more than willing to cover any reasonable costs. Please inform me (via the contact information provided) of the applicable fees and the preferred method of payment. Given the urgency of this matter, I kindly request that you process my request as soon as possible. Should you have any questions or require additional information to fulfill this request, please do not hesitate to contact me. Thank you for your prompt attention to this matter. I truly appreciate your ongoing commitment to providing quality healthcare services to your patients. Sincerely, [Your Full Name] [Your Contact Information] [Date]