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Medical records request

This creates an editable text draft. Check the recipient’s format and local requirements. Use Elyaz to make a PDF in your own handwriting.

Details

[Recipient]

Could you please send me a copy of my medical records from my visit on [Date]?

[Date]
[Full name]

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When to use this template

This template is for asking a clinic or hospital for a copy of your medical records from a particular visit. It identifies the visit by its date and asks for a copy to be sent to you.

What the letter contains

  • There is no Message field; the visit is identified only by its date.
  • Date is the day of the visit, used in the question and repeated above your name.
  • It is phrased as a polite question asking for a copy of the medical records.
  • Recipient is the clinic, hospital or doctor's practice that holds the records.
  • Your full name and, if added, your ID number help the practice find your file; an address is printed under them when you enter one.

More templates in this category

Category: Health

Source · Elyaz

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