Home » Letter Sample » Request Letter » Second letter requesting copies of medical records

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

Share on Facebook
Share on Twitter
Share on Google+

Related : Second letter requesting copies of medical records

  • Letter requesting no release of medical recordsDescriptionThis letter template requests your healthcare provider not release any of your medical records to any person or organization. This privacy request is accompan ...
  • Letter requesting salary increase for length of serviceDescriptionAfter a period of time in your job position, use this letter template to request a meeting with your manager to discuss a salary increase. To justify the incr ...
  • Letter of complaint about insurance premium increase[Date][Recipient Name][Title][Company Name][Street Address][City, ST ZIP Code]Dear [Recipient Name]:I just received my annual bill for auto insurance and nearly had ...
  • Letter requesting street address for orderDescriptionThis letter template acknowledges a customer's request to deliver their order to a different address, and requests they provide the new address as soon as pos ...
  • letter to insurance company requesting coverageHealth insurance letter is written by person who has taken an insurance policy from any of the insurance company. By writing health insurance appeal letter the person ca ...
  • Letter notifying employee of layoffHow to write letter or email notifying employee of layoff.[Date][Recipient Name][Street Address][City, ST ZIP Code]Dear [Recipient Name]:As you may know, recent cha ...
  • Thank you letter for phone interviewDear :It was a pleasure speaking with you on the phone last week.I want to thank you for arranging for me to meet with Bryan Baker on Monday, July 21, at 10:30 A.M. ...
  • Welcome letter for new business associateSubject: Welcoming to become part of our Retailer ChainDear Ricky,We welcome you as our new retailer for our line of Sports Merchandise. We are happy that you agreed to ...
  • Inquiry letter for catalogue of the machines To,Jackson Brothers.3487 23rd StreetNew York, NY 120009September 23, 2010.Dear Kenneth,With reference to our telephonic conversation, we are writing to enquire whet ...
  • Notice of rent increase sample letterHow to write Notice of rent increase sample letter or email[Date]To:          [Tenant’s Name]This is to inform you that ...
  • Resume cover letter for unsolicited resume[Date][Recipient Name][Title][Company Name][Street Address][City, ST  ZIP Code]Dear [Recipient Name]:Are you looking for a [job title] with:·&nb ...
  • Quotation acceptance letter to vendorTo,Henry G. Rowe71 Holgate RdLE7 1ZRRATCLIFFE ON THE WREAKEDate: 19th August 2010Dear Mr. Henry,Yesterday I checked your quotation and its impressive. As you have m ...
  • Letter apologizing for delayed orderHow to write apology letter against complaint received for delay in order[Date][Recipient Name][Title][Company Name][Street Address][City, ST ZIP Code]Dear [Re ...
  • Love letter with birthday wishesDear Ethan,Wish you a very Happy Birthday!!!This birthday I would like to tell you my feeling for you, Ethan I love you and want ...
  • Letter to unqualified job applicants[Date][Recipient Name][Title][Company Name][Street Address][City, ST ZIP Code]Dear [Recipient Name]:Thank you for your interest in the [job title]position now ...