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SUN DOWNSTATE MEDICAL CENTER UNIVERSITY HOSPITAL OF BROOKLYN POLICY AND PROCEDURE No. Subject: PATIENT REQUESTS FOR ACCESS Page 1Prepared by:Original Issue Date11/02Supersedes:09/13Effective Date:08/17Shoshana
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How to fill out subject patient requests for

01
Step 1: Obtain the subject patient request form from the relevant authority or organization.
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Step 2: Read the instructions and requirements mentioned on the form carefully.
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Step 3: Fill out your personal information accurately, including your full name, contact details, and any identification numbers required.
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Step 4: Provide a detailed description of the reason for the subject patient request, clearly stating what information or records you are seeking.
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Step 5: Attach any supporting documents or evidence that may be required for the request.
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Step 6: Review the completed form to ensure all information is accurate and legible.
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Step 7: Submit the filled-out subject patient request form to the designated authority or organization via the prescribed method (e.g., in-person, mail, online submission).
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Step 8: Keep a copy of the filled-out form and any supporting documents for your records.
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Step 9: Wait for the response from the authority or organization regarding your subject patient request.
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Step 10: Follow up with the relevant authority or organization if you do not receive a response within the specified timeframe.

Who needs subject patient requests for?

01
Patients who require access to their own medical records.
02
Individuals conducting research or studies that require specific patient data.
03
Legal representatives or guardians of a patient who need to request information on behalf of the patient.
04
Government agencies or law enforcement organizations with proper authorization investigating medical-related cases.
05
Insurance companies or healthcare providers processing claims or accessing patient information for legitimate purposes.
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Subject patient requests are for requesting access to a patient's medical records or personal health information.
Subject patient requests can be filed by the patient or their authorized representative.
Subject patient requests can typically be filled out by completing a form provided by the healthcare provider or submitting a written request.
The purpose of subject patient requests is to allow patients to access their own medical records and personal health information.
Subject patient requests may need to include the patient's identifying information, the specific records requested, and the reason for the request.
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