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MANILA DOCTORS HOSPITAL COMMITTEE ON MEDICAL EDUCATION AND TRAINING667 United Nations Avenue Ermina, ManilaREQUIREMENTS FOR RESIDENCY/FELLOWSHIP TRAINING (2 copies of the following except for I'm
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How to fill out medical record request letter

01
Begin by writing your name and contact information, including your address, phone number, and email address, at the top of the letter.
02
Next, include the name and contact information of the healthcare provider or facility from which you are requesting the medical records. This should include their name, address, phone number, and any other necessary contact information.
03
Clearly state the purpose of your letter and your request for copies of your medical records. Be specific about the dates of the records you are requesting and any specific documents or tests you need copies of.
04
Include any necessary personal information that may be required to identify your records. This may include your full name, date of birth, social security number, and any patient identification numbers provided by the healthcare provider.
05
State whether you would like physical copies of the records or if you would prefer them to be sent to you electronically. If you prefer electronic copies, provide your preferred format, such as PDF or electronic file through a secure portal.
06
Mention any time constraints or deadlines for receiving the medical records, if applicable.
07
Include a statement of consent, authorizing the release of your medical records to you.
08
Sign and date the letter at the bottom, and consider enclosing a copy of your identification for verification purposes.
09
Keep a copy of the letter for your own records and send the original letter via certified mail or a reputable courier service to ensure its delivery.
10
Follow up with the healthcare provider or facility to confirm receipt of your letter and to inquire about any fees or processing time for your request.

Who needs medical record request letter?

01
Anyone who wishes to obtain copies of their own medical records from a healthcare provider or facility would need a medical record request letter. This may include patients who are seeking copies for their personal records, those who require the records for legal purposes, or individuals who are transferring care to a new healthcare provider and need to provide their medical history.
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The medical record request letter is a written request for a person's medical records from a healthcare provider.
Anyone who wants to access their own medical records or obtain medical records for someone else is required to file a medical record request letter.
To fill out a medical record request letter, you will need to provide your personal information, the name of the healthcare provider, the dates of service, and the reason for the request.
The purpose of a medical record request letter is to obtain copies of medical records for personal use, legal matters, insurance claims, or to provide to another healthcare provider.
The medical record request letter must include the patient's name, date of birth, contact information, the name of the healthcare provider, dates of service, and a signature authorizing the release of the records.
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