Asking for your own medical records, step by step
You have a legal right to your chart. Here is how to ask for all of it, and how to know when something is missing.
Most people ask for a summary and get one. A summary is what a hospital chooses to say about your care. The chart is what it recorded while the care was happening, and the two are often different.
Who to write to
Each hospital, clinic and doctor’s office keeps its own records. Start with the place where you believe the problem began, then ask the others. Look for the medical records or health information department; its address is usually on the hospital’s website or on a bill.
What to ask for
- The complete chart for the dates in question
- Imaging, with the images themselves and not only the reports
- Lab results, with the times they were taken and reported
- Nursing notes and medication logs
- Any incident or follow-up notes
- Billing statements, which show what was done and when
Ask in writing
A short letter or a form from the hospital is enough. Give your full name, date of birth and the dates of care, and say you want a complete copy. Keep your own copy of the request and note the date you sent it.
How to tell if something is missing
Read the pages in order. Gaps in times, a test mentioned but never reported, or notes that stop and then start again hours later are worth marking in pencil. You do not have to understand all of it. A physician reading it later will.
What happens next
If you decide to talk to a lawyer, bring the records exactly as you received them. We would rather see an untouched copy than one you have sorted or highlighted. This guide is general information, not legal advice.