Medical Records Request Generator

Generate a HIPAA-compliant medical records request letter ready to print on your letterhead.

Starting template only. State law and provider requirements vary. Review against your jurisdiction before sending.

This tool is different from most of ours: to generate a usable letter, the form fields (including patient name, DOB, and address) are transmitted to Anthropic’s API. We don’t log the content, and Anthropic doesn’t train on it. If you want to test the tool without PHI, use placeholders like [PATIENT], [DOB], [FIRM] — the letter will come back with those placeholders intact for you to fill in locally. How Prevaldi handles your data →

Use real info for a usable letter, or placeholders like [PATIENT] to test the format first.

Signed HIPAA authorization, referral, prior correspondence. PDF, image, Word. Up to 3 files, 10 MB each.

Output will appear here once the tool runs.

Questions people ask first

What does this tool produce?

A HIPAA-compliant medical records request letter ready to print on your letterhead. Patient information, provider information, date range, scope, and the authorisation language a records custodian needs to release.

Is the language actually HIPAA-compliant?

The standard authorisation language and the elements required by 45 CFR 164.508 are present. State-specific add-ons (some states have stricter requirements — California, Texas, Florida especially) are flagged but you should confirm your jurisdiction's specifics before sending. The tool is a fast draft, not a substitute for knowing your state's rules.

What inputs do I need?

Patient's full legal name and date of birth, provider's name and address, the date range of records being requested, and the scope (full records, specific dates, specific procedures, billing only, etc.). Use placeholders if your firm's policy keeps PHI off web tools — the letter structure still works.

Will it generate an authorisation form too?

It generates the language a custodian needs. Whether your client signs a separate authorisation form (HIPAA Authorization, your state's specific form) or signs the letter directly is your choice. The output gives you both options.

What about subpoenas for medical records?

Different document. This tool is for client-authorised records requests under HIPAA. For subpoenas duces tecum, you need your jurisdiction's subpoena form and the specific notice provisions your state requires for medical records — those add-ons are not what this tool produces.