Need your medical records moved? A “Sample Letter To Transfer Copy Of Medical Records” helps you do just that. You’ll use it when switching doctors. It’s also handy when seeking a second opinion.
Writing this letter can feel daunting. Where do you even start? Don’t worry, we’ve got you covered.
We’re sharing letter templates. These samples make transferring your records easy. Use them as a guide to craft your own letter.
Sample Letter To Transfer Copy Of Medical Records
[Your Name]
[Your Address]
[Your City, State, Zip Code]
[Your Phone Number]
[Your Email Address]
[Date]
[Recipient Name or Medical Records Department]
[Hospital/Clinic Name]
[Hospital/Clinic Address]
[Hospital/Clinic City, State, Zip Code]
Subject: Request to Transfer Medical Records
Dear [Recipient Name or To Whom It May Concern],
I am writing to request a copy of my medical records be transferred to the following healthcare provider:
[New Doctor’s Name]
[New Clinic/Hospital Name]
[New Clinic/Hospital Address]
[New Clinic/Hospital City, State, Zip Code]
My personal information is as follows:
* Full Name: [Your Full Name]
* Date of Birth: [Your Date of Birth]
* Social Security Number (Optional): [Your Social Security Number]
Please include all records, including but not limited to, doctor’s notes, lab results, imaging reports, and immunization records.
I would appreciate it if you could send the records securely to the address listed above as soon as possible.
Please let me know if you require any additional information or have any questions. You can reach me at the phone number or email address listed above.
Thank you for your time and assistance.
Sincerely,
[Your Signature]
[Your Typed Name]
How to Write Letter To Transfer Copy Of Medical Records
Subject Line: Clarity is Paramount
The subject line is your initial communiqué. It must be succinct and directly state the purpose of your letter. Avoid ambiguity; precision is key.
- Be direct: “Request for Medical Records Transfer” or “Authorization to Release Medical Records.”
- Include your full name and date of birth for immediate identification. Example: “John Doe, DOB: 01/01/1990 – Medical Records Transfer Request.”
Salutation: A Formal Overture
Begin with a professional greeting. A correct salutation sets a respectful tone for your correspondence.
- If you know the recipient’s name, use “Dear Dr. [Last Name],” or “Dear Mr./Ms. [Last Name].”
- If the recipient is unknown, “To Whom It May Concern,” is acceptable, albeit less personal.
Body Paragraph 1: Articulating Your Request
Clearly and concisely explain your purpose in the opening paragraph. Leave no room for misinterpretation.
- State that you are requesting a copy of your medical records to be transferred.
- Specify the reason for the transfer, even briefly. For instance, “for ongoing medical care” or “for personal records.”
- Include your full name, date of birth, and current address, re-emphasizing your identity.
Body Paragraph 2: Destination Details
Provide comprehensive information about where to send your records. Accuracy averts potential delays.
- Include the full name of the receiving entity (doctor’s office, hospital, etc.).
- Provide the complete address: street address, city, state, and zip code.
- If available, include a contact person and phone number at the receiving entity.
Body Paragraph 3: Specifying Records and Format
Indicate which records you need and the preferred format. Be explicit to avoid incomplete transfers.
- Specify the date range of the records you require. If you need all records, state “all records from [date] to present.”
- Indicate your preferred format: electronic (PDF), paper, or CD.
- If requesting electronic records, ensure the recipient’s office can receive them securely.
Closing: Professional Demeanor
End your letter with a polite and professional closing. Reinforce your expectations succinctly.
- Use a formal closing: “Sincerely,” “Respectfully,” or “Yours Truly.”
- Leave space for your signature.
- Type your full name below the signature line.
- Consider adding your phone number and email address for ease of contact.
Postscript: Supplementary Information
A postscript (P.S.) can be used for crucial, supplementary details. Use it judiciously.
- If you require expedited processing, mention it here.
- State that you are willing to cover any reasonable fees associated with the record transfer.
- Reiterate your contact information if you feel it’s necessary.
Frequently Asked Questions: Transferring Medical Records
Transferring your medical records is a critical step when changing healthcare providers. Below are answers to some of the most common questions regarding requesting a copy of your medical records for transfer.
How do I formally request my medical records be transferred?
You must submit a written request, often using a form provided by your healthcare provider or a signed letter. Your request should include your identifying information, dates of treatment, and where to send the records.
What information should I include in my transfer request letter?
Include your full name, date of birth, address, phone number, the name and address of the healthcare facility receiving the records, the specific records you need, and a signed authorization.
Is there a standard format for a medical record transfer letter?
While no single mandated format exists, using a template or the healthcare provider’s form ensures all necessary information is included. Ensure completeness and clarity in your request.
How long does it take to transfer medical records?
The transfer timeframe varies, but typically it takes between 7 to 30 days, depending on the healthcare provider’s policies and the complexity of the request. Follow up if needed.
Are there any fees associated with transferring medical records?
Fees may apply for the copying and transfer of medical records, as allowed by law. Contact your healthcare provider to understand their specific fee schedule beforehand.