Medical Records Request
Form to obtain copies of health records.
Detailed Explanation
A Medical Records Request is a formal request for copies of health records from a healthcare provider or facility. Under HIPAA, patients have the right to access and obtain copies of their medical records (with limited exceptions). The request must specify: patient name and identifying information, records requested (date range, specific departments, types of records), preferred format (paper, electronic), and delivery method. The request must include patient signature or signature of authorized representative with documentation of authority. Providers typically have 30 days to respond (with one 30-day extension allowed) and may charge reasonable fees for copying and mailing. Patients may request records for: personal use, second opinions, changing providers, legal matters, or insurance claims. Electronic health records have made obtaining copies easier, and many patients now have online portal access to records. Prompt access to complete, accurate medical records improves care coordination and patient engagement.