Patient request to access Health Records 2026

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  1. Click ‘Get Form’ to open the Patient request to access Health Records in the editor.
  2. Begin by filling out the 'Patient Details' section. Enter your URN (if applicable), surname, given names, maiden name, date of birth, sex, address, suburb, state, phone number, mobile number, Medicare number, and pension number if you qualify for a discount.
  3. If you are not the patient requesting access, complete the 'Requestor' section with your details and relationship to the patient.
  4. Select the type of access you require: viewing access only or printed copies. Specify which facility you attended and what records you would like to view or receive copies of.
  5. For specific requests such as Time of Birth or Medical Certificates, fill in the relevant fields and indicate any additional information needed.
  6. Sign the consent on page 2 authorizing the release of information. Ensure all required signatures are completed before submission.
  7. Once completed, return your form via fax or email as indicated on the document.

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A federal law called the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule gives you the right to see and get a copy of your health record. Health plans and most including most doctors offices, clinics, hospitals, pharmacies, labs, and nursing homes must follow this law.
The patient or patients representative is entitled to copies of all or any portion of their records that he or she has a right to inspect, upon written request to the physician.
In particular, the federal medical privacy law, the Health Insurance Portability and Accountability Act commonly known as HIPAA, provides a patient the right to obtain an electronic copy of their medical record in the patients preferred form and format, as long as your practice is technically able to do so.
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 request copies of the following [or all] health records related to my treatment. [Identify records requested, e.g. medical history form you provided; physician and nurses notes; test results, consultations with specialists; referrals.] [Note: HIPAA also allows you to request a summary of your medical records.

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Right to access: The Privacy Rule requires medical providers to grant individuals access to their PHI upon written request. Providers must supply a copy of the requested information within 30 days.
Documents to download Patients have a right to access their own health records and for their records to be kept private, although there are some exceptions (such as when sharing health records is required by law to keep people safe or to help manage healthcare services).

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