Second letter to request copies of medical records
Here is a sample second letter to request copies of medical
records. You have to customize this letter with required information to be
suitable for your purpose.
Alex J. Roberts
[Street Address]
[City, ST ZIP Code]
[Date]
Mark k. Anderson
[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 Mr. Anderson,
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,
Alex J. Roberts
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