Dear Medical Records Department 2025

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  1. Click ‘Get Form’ to open the Dear Medical Records Department document in the editor.
  2. Begin by entering the date of your letter at the top of the form. This is important for record-keeping purposes.
  3. Fill in the hospital or care provider's name, street address, city, state, and zip code in the designated fields.
  4. In the 'RE:' section, specify any relevant details that pertain to your request for medical records.
  5. Address the letter directly to the Medical Records Department and provide a brief introduction about your request.
  6. Clearly outline the time frame of treatment by filling in the start and end dates along with a description of the condition treated.
  7. List all specific medical records you are requesting, ensuring clarity on what documents you need for your files.
  8. Include your signature at the bottom of the form along with your address, city, state, zip code, and phone number for contact purposes.

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Abstract. Medical Record Department (MRD) is the systematic documentation of a patients medical history and current treatment and care given to the patient.
Use certified mail or a delivery service that tracks packages. This allows monitoring in case the mail goes astray. Encrypt digital files and provide the password separately if emailing records. Encryption guards against hacking of intercepted emails.
How you make your request will depend on your providers processes. You may be able to request your record through your providers patient portal. You may have to fill out a form called a health or medical record release form, or request for accesssend an email, or mail or fax a letter to your provider.
I was treated in your office [at your facility] between [fill in dates]. I request copies of the following [or all] health records related to my treatment. [Identify records requested (e.g., medical-history form you filled out; physician and nurses notes; test results; consultations with specialists; referrals).]