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Sample Medical Records Request Form Template
Medical Records Request Basics

A Medical Records Request can help you get ahold of your medical documents when you need them. If you've moved, need to see a specialist, or are simply switching practitioners, you may need to request copies of your records. Your doctor is prohibited from releasing your information without authorization, but a Medical Records Request can help free up your information so you can send it where it needs to be.

Use the Medical Records Request document if:

  • You moved and need to see a new doctor.
  • You're switching doctors.
  • You're seeing a specialist.
  • You manage a medical office and need patient documents available.
  • You have a new insurance company, and your current doctor is no longer in your network.

Different doctors may have different rules, but medical information is confidential. You'll likely need a Medical Records Request if you want your doctor to send your information to another physician - and it'll probably need to be in writing. A written request for your medical records helps document the transfer and can ensure everything goes as smoothly as possible. Your medical records are important and your new doctor needs to know your medical history to give you the best treatment possible. A Medical Records Request can get you your important documents so can switch doctors, see a specialist, or simply get copies for your own records.

Other names for this document: Medical Records Request Form, Letter to Request Medical Records

Sample Medical Records Request

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