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  • A Letter of Request

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    Eliz Janneca Palmera
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    Eliz Janneca L. Palmera writes a letter to Dr. Marlowe Duay requesting a copy of her medical records from treatment at the Duay Clinic between March 10-11. She cites regulations that allow patients access to their records and asks that copies be provided within 20 days as required by law. If the request cannot be fulfilled within that timeframe, she asks to be notified of the expected date the records will be available.

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    PALMERA LETTER OF REQUEST

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    Eliz Janneca L. Palmera writes a letter to Dr. Marlowe Duay requesting a copy of her medical records from treatment at the Duay Clinic between March 10-11. She cites regulations that allow patients access to their records and asks that copies be provided within 20 days as required by law. If the request cannot be fulfilled within that timeframe, she asks to be notified of the expected date the records will be available.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    39 views1 page

    A Letter of Request

    Uploaded by

    Eliz Janneca Palmera
    Eliz Janneca L. Palmera writes a letter to Dr. Marlowe Duay requesting a copy of her medical records from treatment at the Duay Clinic between March 10-11. She cites regulations that allow patients access to their records and asks that copies be provided within 20 days as required by law. If the request cannot be fulfilled within that timeframe, she asks to be notified of the expected date the records will be available.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    A LETTER OF REQUEST

    Eliz Janneca L. Palmera


    Martinez Subd., City of Mati
    09666810505
    Email: eljanneca@gmail.com

    March 15, 2020

    Dr. Marlowe Duay


    Head, Clinic Department
    Duay Clinic
    Cabadbaran, Agusan Del Norte

    Dear Dr. Duay,

    I am writing to request a copy of my medical records as allowed by the Department and Human
    Services regulations and Health Insurance Portability and Accountability Act (HIPAA).

    I was treated in your office between March 10-11. I request copies of the following health
    records related to my treatment.

    I look forward to receiving the above records within 20 days as specified under HIPAA. If my
    request cannot be honored within 20 days, pleased inform me of this by letter as well as the date
    I might expect to receive my records.

    Respectfully,
    Eliz Janneca L. Palmera
    ELIZ JANNECA L. PALMERA

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