A Medical Records Request Form is a form that is used to request copies of medical records from a doctor, clinic, or any medical institution. You may need copies of your medical records or other medical documents in cases where you’ve relocated to a new geographic location, are consulting with a new doctor, or you are seeking help from a specialist who needs to see your medical history.
Due to the stringent confidentiality and privacy laws applicable in many cities, your medical records or documents cannot be simply handed over to anyone. Your doctor or clinic cannot simply give out your medical history without your authorization. In all these examples mentioned above, you have to put in a formal request by signing and submitting the medical records request form, which is also known as the ‘Letter to Request Medical Records’ template.
How to use Medical Records Request Form
Depending on where you live or what type of doctor you consult with, the rules and format for the medical records request form will be different. Local & state laws vary from place to place, and so it is important to understand how to write a letter requesting medical records. A written request to ask for your medical records is generally the best option, as it ensures that your doctor retains a copy of your request and also helps in ensuring that everything goes as smoothly as possible.
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Below is a sample letter requesting medical records that you can download as a PDF template and fill out a copy of the letter for requesting medical records from your doctor. This PDF template will tell you how to request medical records in writing, and also works as a generic medical records request form in most cases.
Medical Records Request Form Template
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Medical Records Release Authorization Form
In the section above, we’ve outlined what a Request of Medical Records Form is and how you can download the Free Medical Records Request template and edit it with your own information. With that form, your medical records will be shipped or emailed to you in a few days.
However, you may not always need a copy of those medical records yourself. At times, you may need to authorize someone else, such as your family members, relatives, or other doctors, to request medical records on your behalf. In these cases, you need to submit a Medical Records Release Authorization Form, which authorizes the mentioned party to receive the medical records on your behalf.
By signing the authorization form for release of medical records, you are officially requesting that your confidential health information be released or given to the party authorized & detailed by you in the form.
Medical Records Release Template
Click here to download the Free Medical Records Request Template shown above.
You can download and edit this medical records release form PDF using PDF Expert — the best PDF Editor for Mac. Using PDF Expert, you can fill out the blank fields in the form using your computer, without having to print out a copy and writing it by hand. PDF Expert offers all the tools you need to work with PDFs in an intuitive experience.