This affidavit is to be used by the custodian of medical records to certify that records obtained by the attorney regarding the client's treatment are true and correct copies.
Louisiana Affidavit of Custodian of Medical Records
State:
Multi-State
Control #:
US-PI-0007
Format:
Word;
Rich Text
Instant download
Description
How to fill out Affidavit Of Custodian Of Medical Records?
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FAQ
In Louisiana you have the right to: See and get a copy of your medical record. called the right to access your medical record. Your health care provider is allowed to charge you a fee for copying your record.
Louisiana Laws for Adults' Medical Record Retention Medical and dental records shall be retained by a physician or dentist in the original, microfilmed, or similarly reproduced form for a minimum period of six years from the date a patient is last treated by a physician or dentist.
On average, a health record book can cost you around $25 to $40.
If the treatment records exist solely in paper form, paper or digital copies shall be provided upon payment of a reasonable copying charge, not to exceed one dollar per page for the first twenty-five pages, fifty cents per page for twenty-six to three hundred fifty pages, and twenty-five cents per page thereafter, a ...
Louisiana Revised Statutes 65.1 For records, a reasonable charge not to exceed: Paper / Microfilm: $1.00 per page for first 25 pages. $0.50 per page for pages 26-350.
(1) "Affidavit" means a written accusation of crime made under oath and signed by the affiant. It must be filed in open court in a court having jurisdiction to try the offense or in the office of the clerk thereof.
Affidavit for small succession; contents. (9) An affirmation that, by signing the affidavit, the affiants swear under penalty of perjury that the information contained in the affidavit is true, correct and complete to the best of their knowledge, information, and belief.
Generally, your health care provider must give you a copy in the format that you request if they are able to do so. Your provider may charge you a fee to copy your medical record.
