Second letter requesting copies of medical records

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Second letter requesting copies of medical records

Description

Follow up on a request for copies of your medical records with this letter template. The letter states a legal requirement to provide the records, and sets a deadline for receipt, after which time an attorney will be hired to obtain the records.

User
[Street Address]
[City, ST  ZIP Code]
[Date]

[Doctor Name]
[Medical Practice or Hospital Name]
[Street Address]
[City, ST  ZIP Code

RE:          Release of medical records for User
DOB: [date], SSN: [Social Security Number]

Dear [Doctor Name]:
On [date], I sent you a written request asking for copies of my medical records related to treatment for [medical conditions] rendered by you or under your supervision from [date] through [date]. Since then, [number] days have passed and I have not yet received these records.
I am hereby making a second request that you send me these records immediately. I remind you that under the laws of this state, Statute #[number], you are legally obligated to provide copies of my medical records upon my request.
If I have not received the records by [date], I will have no choice but to retain an attorney to obtain my medical records for me. By law, you will then be liable for the attorney fees that I incur. I trust that this step will not be necessary.
Please mail the information to:
[Your Name or Name of Party to Receive Records]
[Street Address]
[City, ST  ZIP Code]
As noted in my first request, I will be glad to pay for costs associated with providing me copies of my records.
Sincerely,
User


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