Kentucky Sample Letter for Medical Authorization for Client Medical History
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How to fill out Sample Letter For Medical Authorization For Client Medical History?
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FAQ
Providers and Hospitals: Medical records shall be retained for at least six (6) years from date of discharge, or three (3) years after the patient reaches the age of majority under state law, whichever is the longest.
You can not obtain a family member's medical record unless you have power of attorney, guardianship or are the executor of the patient's estate.
I was treated in your office [at your facility] between [fill in dates]. I request copies of the following [or all] health records related to my treatment. [Identify records requested (e.g., medical-history form you filled out; physician and nurses' notes; test results; consultations with specialists; referrals).]
Authentication of medical record entries may include written signatures, initials, computer key, or other code. For authentication, in written or electronic form, a method must be established to identify the author.
(1) Upon a patient's written request, a hospital licensed under KRS Chapter 216B or a health care provider shall provide, without charge to the patient, a copy of the patient's medical record.
Example, if your provider maintains paper medical records, they own and have the right to keep the original record, but you have the right to see and get a copy of it.
You may submit a letter identifying the records sought or complete and submit a Division of Health Care - Open Records Request Form. Please be sure to provide your name, address and daytime telephone number in the event we need to contact you. All requests for records must be signed by the requester.
