Family ClaimWrongful Death
Wrongful-Death Compensation Calculator
Estimate support loss, funeral costs, medical bills, and relationship-based wrongful-death damages.
JusticeFinder Tool
Medical Records Request Letter Generator
Your records are the backbone of any injury claim, and federal law gives you the right to a copy within 30 days. Fill in a few fields and the generator writes a clean, citation-correct HIPAA request letter you can print, email, or hand to the records department today.
Build your records request
Enter your details and the provider you're requesting from. The HIPAA letter previews on the right and updates with every keystroke — then copy or download it.
Estimates update live. Use reset to restore starter examples.
Letter status
Start filling it in
0% complete
Preview
[Your name] [Your email / phone] August 4, 2026 [Provider / facility name] Attn: Release of Information / Medical Records [Provider mailing address] Re: Patient Request for Medical Records under HIPAA Right of Access Patient: [Patient name] · DOB: [date of birth] Dates of service: [start date] – present To the Release of Information Department: I am the patient named above (or the patient's personal representative) and I am exercising my right of access under the HIPAA Privacy Rule, 45 CFR § 164.524, to obtain a copy of my complete medical record for the dates of service listed above. Please provide these records as electronic PDF copies. If any portion cannot be released, please send what is available and identify what is withheld and why. Federal law requires you to act on this request no later than 30 days from receipt. If a fee applies, it must be limited to the reasonable, cost-based amount permitted under § 164.524(c)(4); please notify me in advance if it will exceed $25. Thank you for your prompt attention. You may reach me at the contact information above with any questions or to confirm receipt. Sincerely, [Your name]
This letter is generated in your browser from what you enter — nothing is saved or sent. Bracketed fields fill in as you complete the form.
How to use this tool
- Open the letter generator. Scroll to the draft builder and review the sample fields so you know which facts the letter needs.
- Fill in parties, dates, and damages. Enter claimant and insurer details, accident facts, medical bills, wage loss, and any evidence list you will attach.
- Generate and review the draft. Create the letter, then edit tone, demand amount, and attachments so every statement matches your records.
- Copy, download, or print. Save the draft, keep supporting PDFs ready, and get a human review before you send anything to an insurer.
Read JusticeFinder elsewhere
Short legal explainers on TikTok, visual case briefs on Instagram, daily threads on Threads — same independent editorial.
JusticeFinder Guides
Recommended Guides for Claim Strategy
Pair this calculator with the free adjuster tactics playbook and the paid claim kit to keep documentation, valuation, and negotiation aligned.
Car AccidentPremiumCar Accident Master Claim KitComplete 10-step documentation system for the first 30 days after a crash.$37View guide →
Insurance DefenseFreeInsurance Adjuster Tactics Expose + Defense PlaybookFree lead magnet exposing the 12 tactics insurers use to reduce or deny claims.FreeView guide →Your HIPAA right of access
Three rules worth knowing before you send the request.
30-day deadline
Providers must respond within 30 days of a written request. One 30-day extension is allowed with written notice.
Cost-based fees only
They may charge a reasonable, cost-based fee for copies — not a per-page profit markup or a separate search fee.
Your format, your choice
If records are electronic, you can ask for them electronically and have them sent where you direct.
What to ask for — and why
A request that captures the full record protects the value of your claim.
Ask for the complete chart. Request the full record — notes, labs, imaging reports, and medication history — not just a visit summary. Gaps in the chart become gaps in your claim.
Get the itemized bill too. The itemized statement with billing codes is what proves the dollar value of your treatment. Request it alongside the clinical record so your damages are fully documented.
Keep proof of when you sent it. The 30-day clock runs from receipt, so send the request in a way you can document and note the date in your file.
Related Resources
Use these pages and documentation tools to validate the estimate, preserve evidence, and keep the claim file organized.
Related Tool
Evidence Checklist & Organizer
Track which records, photos, and proof you still need so the request letter fits into a complete claim file.
Next Step
Demand Letter Generator
Once your records are in hand, turn them into a structured settlement demand.
Related Tool
Net Settlement Calculator
Model what a settlement actually nets you after fees and the liens your records help document.
Spreadsheet
Medical Records Tracker
Log each provider, request date, and follow-up so no record falls through the cracks.
Settlement Prep
Demand Letter Organizer
Organize the records and bills into the damages package an adjuster takes seriously.
Frequently Asked Questions
Do I have a right to my own medical records?
Yes. The HIPAA Privacy Rule, 45 CFR § 164.524, gives patients (and their personal representatives) a right of access to a copy of their medical and billing records held by covered providers.
How long does a provider have to respond?
A provider generally must act on a written request within 30 days of receipt. One 30-day extension is allowed if they notify you in writing of the delay and the reason.
Can they charge me for copies?
Only a reasonable, cost-based fee under § 164.524(c)(4) — not a per-page profit markup or a separate search fee. If records are electronic, the cost-based limit still applies.
Can I get the records electronically?
If the provider maintains the records electronically, you can ask for an electronic copy and direct where it is sent, such as a secure download or your patient portal.
What should I actually request?
Ask for the complete chart — notes, labs, imaging reports, and medication history — plus the itemized billing statement. Gaps in the record become gaps in your claim.
Educational Use Disclaimer
This tool is for educational use only and does not create an attorney-client relationship or constitute legal advice. The letter reflects your federal right of access under 45 CFR § 164.524; some providers use their own authorization forms and state law may add requirements. Review the finished letter before sending and consult a licensed attorney about your claim.
Explore More JusticeFinder Tools
Related calculators in this claim stage. Browse the full library for every damages, coverage, and deadline tool.
Settlement PrepDemand Letter
Personal-Injury Demand Letter Generator
Create an editable personal-injury demand letter draft with damages, evidence, and settlement language.
Evidence PrepEvidence Checklist
Personal-Injury Evidence Checklist & Organizer
Build a tailored evidence checklist for records, photos, witnesses, wage proof, experts, and missing claim documents.
Evidence PrepSpoliation Letter
Spoliation / Evidence Preservation Letter Generator
Build a certified-mail spoliation letter that preserves the evidence your accident type depends on.
Continue Exploring
Move from calculator estimates into documentation, deeper guides, or the rest of the JusticeFinder tool library.