Money, insurance and health

Ask for your medical records

Ask a doctor’s office or hospital for a copy of your records.

Your details

Type in the boxes and the letter below changes as you type. Anything you leave empty stays in brackets.

Doctor’s office or hospitalPatient name and date of birthWhich recordsHow you want themHow to reach youYour name

Your letter

Hello [doctor’s office or hospital], I am writing to ask for a copy of my medical records. Patient: [patient name and date of birth] Records: [which records] Please send them: [how you want them] Please let me know if you need a form, a copy of my ID, or a payment for the copies. You can reach me at [how to reach you]. Thank you, [your name]

How to use it

Many offices have their own form. Ask for it, and use this letter if they do not.
Say which records and which dates you need, and how you want them (paper or electronic).
The office may ask for photo ID and may charge a fee for copies.