Medical records request letter
Ask your hospital or doctor for copies of your own records. Write the request here, then send it yourself.
Free. No sign-up. No uploads. Your entries are not sent to a server, saved, logged, or included in analytics. Copying and printing are actions you choose on your device.
Your letter
Review the details before signing. Send the letter yourself to the provider’s medical records office and keep a dated copy.
Fill in your details and choose “Create letter” to see your request here.
Your rights
HIPAA gives you access to records about you in a covered provider’s designated record set, subject to specific exceptions. This includes medical and billing records; psychotherapy notes and information compiled for legal proceedings are excluded. 45 CFR 164.524(a).
- Response time
- The rule says the provider “must act on a request for access no later than 30 days after receipt of the request.” It may extend the time “by no more than 30 days,” with “only one such extension of time.” Within the initial deadline, it must give written reasons and the date it will complete the request. 45 CFR 164.524(b)(2). HHS specifies calendar days.
- Copying fees
- A provider may charge a “reasonable, cost-based fee,” limited to copying labor, permitted supplies, requested postage, and an explanation or summary you agree to. Search and retrieval costs are not included. 45 CFR 164.524(c)(4); HHS Right of Access guidance.
- For electronic copies of records maintained electronically, HHS permits providers to “charge a flat fee not to exceed $6.50 (inclusive of all labor, supplies, and postage).” This is an optional fee calculation method, not a cap on every request. Other permitted cost-based methods may result in a higher fee. HHS electronic-copy fee FAQ.
- Electronic copies
- For records maintained electronically, the rule requires the requested electronic form and format “if it is readily producible in such form and format”; otherwise, a readable electronic form and format agreed on with you. Electronic copies of paper records depend on whether that format is readily producible. 45 CFR 164.524(c)(2); HHS electronic-access FAQ.
- Directing copies to another person
- You may direct electronic copies from an electronic health record to a designated third party. The request must be written, signed, and clearly identify the person and where to send the copies. HHS’s court-order notice limits this right to electronic copies from an electronic health record and states that the fees for your own access do not apply to third-party transmission. 45 CFR 164.524(c)(3)(ii); HHS court-order notice. This helper writes a request for delivery to you.
If you are requesting for a child or someone who died
This letter is for your own records. For someone else’s records, ask the provider what documents establish your authority as a personal representative under applicable law before adapting it.
A parent or guardian with legal authority to make a child’s health care decisions generally acts as a personal representative. Exceptions apply to some services a minor can consent to or receive confidentially, and state law can affect access.
For someone who died, an executor, administrator, or another person legally authorized to act for the person or estate may qualify. Access is limited to information relevant to that authority. Being a relative alone does not automatically establish full access. Exceptions can also apply in abuse, neglect, or endangerment situations.
General information, not legal advice. Verified against official HHS guidance and current eCFR text on October 6, 2026. Review your provider’s submission and identity-verification instructions before sending.