What is a medical records request letter?
Moving to a new doctor, getting a second opinion, travelling abroad or sorting out an insurance claim often means asking for a copy of your medical records. A phone call can get lost between departments. A short written request, with your date of birth, record number and the exact records you want, is easier for a practice to act on and gives you a dated record of when you asked.
This letter is addressed to the doctor, clinic or hospital and sets out the patient's details, then asks for the complete record or only the parts you list, for the whole period of care or between two dates. You choose electronic copies, paper copies or an appointment to view, and how they reach you. It says what ID you are providing, asks to be told about any fee before the copies are made, and asks for an explanation if anything is withheld. A parent, guardian or representative can make the request instead, and the provider can sign to confirm it arrived.
- Best for
- Patients asking a doctor, clinic, dentist or hospital for their records
- Signed by
- You, plus the provider's acknowledgement of receipt
- Formats
- Electronic copies, paper copies or a viewing appointment
- Length
- 2 pages
When to use a medical records request letter
- Taking your history to a new doctor after a move
- Getting scan images and specialist letters for a second opinion
- A parent asking for a child's vaccination and clinic records
- Gathering test results for an insurance or disability claim
- Keeping your own copy of a hospital stay in your FileIt vault
What you fill in
20 blanks, then the name and email of each person who signs: patient, healthcare provider.
1 The provider
- Date of this letter*
- Doctor, clinic or hospital*
- Their address (optional)
2 The patient
- Patient's full name*
- Patient's date of birth*
- Patient's address*
- Phone or email*
- Patient or record number (optional)
- Who is asking* the patient · a parent or guardian, for a child · a representative with written authority
- Your name, if you are not the patient
3 The records
- Records wanted* the complete medical record · only the records listed below
- Records listed (if not everything)
- Time period* the whole period of care · between the dates below
- From (optional)
- To (optional)
4 Delivery
- Format* electronic copies (PDF or the original file format for images) · paper copies · an appointment to view the records in person
- Send them by* secure email or your patient portal · post to the address above · collection in person
- Email for delivery (optional)
- ID provided*
- Reason (optional)
5 Who signs
- Patient signature and date · The patient, or a parent, guardian or representative asking for them. A representative may need to show their authority.
- Healthcare provider signature and date, job title · The records or practice manager at the doctor, clinic or hospital. They sign only to confirm the request arrived.
What the medical records request letter covers
- Patient details
- Records requested
- Format and delivery
- Fees and timing
Using the medical records request letter, step by step
1 Who you are writing to
Enter the practice, clinic or hospital, ideally its medical records department, and its address if you have it.
2 The patient
Your name fills in from your account. Add date of birth, address, contact and any patient or hospital number. If you are asking for a child or as a representative, say so and add your own name.
3 What you want
Choose the full record or list specific notes, results or letters, and the period. Then pick the format and how you want them delivered.
4 ID and sending
Say which ID you are providing, add a reason only if you wish, sign and send it through FileIt. When the copies arrive, upload them to the patient's folder in your vault.
Tips before you send it
- Check whether your provider has a patient portal or its own request form first. It may be the fastest route.
- Be specific if you only need part of the record. A short request is usually answered sooner.
- Ask for scans and X-rays in their original image format if another doctor will need to read them.
- Note the date you sent the request. Many places set a time limit for answering it.
Sign it online in minutes
- Fill in the blanks. Names, dates and amounts go straight into the agreement — the preview shows exactly where.
- Name who signs. Tick “This is me” for your own part. FileIt builds the PDF with every signature, date box on the right line, and you can check or move anything before sending.
- Send it. Each signer gets a secure link and signs from any device — no account needed. The signed PDF, with an audit trail and a Certificate of Completion, is filed in your vault and emailed to everyone.
Medical records request letter: frequently asked questions
Do I have a right to my medical records?
In many places patients have a legal right to see and copy their records, though the rules, time limits and any fees differ. The letter doesn't quote a specific law, so it works wherever you are; check your local rules if the provider refuses or delays.
Can they charge me?
Some places allow a reasonable fee for copies, others allow none for a first copy. The letter asks the provider to tell you the amount and how it was worked out before preparing them.
Can I ask for someone else's records?
A parent or guardian can usually ask for a young child's records, and a representative with written authority can ask for an adult's. The letter has options for both and asks the provider to say if more proof is needed.
What if part of the record is withheld?
Providers can sometimes hold back information, for example about other people. The letter asks them to say which part and why.
Is an e-signed request accepted?
Many providers accept a signed electronic request, especially by email or portal. If yours wants an ink signature or its own form, print the letter or use theirs.