Request Message to Doctor for Medical Record

1

This message serves to ask for copies of my medical record allowed by the Health Organization Portability Act and Neurology Department. I remained under treatment from [Mention date] to [Mention date]. I request you to please allow me copies of my health records about treatment-related. I can understand that for this process you charge a fee but to locate records you will not charge any fee. I request to email the required record. I am looking forward to receiving the above-mentioned record within three weeks. You can inform me via email if you cannot honor my request within three weeks and tell me the expected date to receive the record.



2

This message has been written to make you a formal request about the issuance of my medical records. I got remain admitted to the cardiology department of your hospital from [Mention date] to [Mention date]. Kindly issue me medical records including blood test results, consultation records written by a doctor, test reports, and recommendations. I request you to please other relevant documents as well that are important to know for other people. I know this well that this is a proper fee for asking for medical record reports and I am ready to pay the charges. Kindly send me the medical record within two weeks. I shall be very thankful to you.



3

I am Biden Steward and had gotten severe injuries and a fractured bone last month in an accident. I was facilitated in your hospital for injuries and remained admitted for two weeks. I suffered from broken ribs and femur and other injuries. I work in a law firm and my employer has asked for my medical record including x-rays, test reports, blood cell reports, treatment plans, diagnoses, recommendations, and visual imagery of diagnosis. I request you to please send me the above-mentioned record via email address and hard copies to my address. If my request has not reached to the concerned custodian, then let me know kindly where to send the request. Thank you for your assistance and cooperation.



4

I am writing this message to request you provide me with hard copies of my medical records. According to the ABC Policy act, I am entitled to have all records of my medical treatment. I remained to admit in neurology department for the treatment of neuropathy. I would like to have copies of my test results including EMG, lumbar puncture report, recommendations by consultants, referrals, blood cell report, and other records. I have read the medical record policy report that you charge a fee for this process. I would like to ask where I have to deposit the payment so may I proceed further? I want a medical record in the next ten days and I request you to send me as soon as possible. I would be very thankful to you for taking attention to this matter.



5

Hope this message finds you in the best of your health. I am Arthur Lewis and last month I remained admitted to your hospital for a week. I had a nervous breakdown and heartache, and it took me seven days to get fully recovered. I work in a private firm and my employer has asked for medical history during the time I was facilitated by you. I got admitted on [Mention date] and got discharged on [Mention date]. You can check from the medical record if am wrong. I request you to send me all the relevant reports and test results in my medical file to my address. I have paid the charging fee for the medical record and sending you its receipt along with this message. I request you to do it on the earliest basis. It would be your great favor for me.



6

I am Jane Steward and resident of Brooklyn Street, 54. I got treatment for a broken leg in your hospital and remained admitted from [mention date] to [mention date]. This message serves to ask for the issuance of medical records including all the documents, x-ray reports, and consultants’ recommendations. As per the guidelines of the hospital, I request you for my all-medical record. My patient ID is [ID] and I need this to submit it to HR of ABC Organization. I am ready to meet all the relevant expenses applicable. You can contact me through the email address or via contact number, in case of queries. I expect to get the earliest response from you.



Request Message to Doctor for Medical Record