Is this medical records request letter really free?

Yes. You fill out the form, download the PDF, and print or mail it — no account, no payment, no email required. We generate the letter and send it back to your browser; we don't save it or log anything you type.

Is this a HIPAA-compliant medical records release form?

The letter invokes your right of access under the HIPAA Privacy Rule (45 CFR 164.524), which lets you get a copy of your own records from a HIPAA covered entity: most doctors, hospitals, clinics, and health plans. A few record holders are outside HIPAA, and psychotherapy notes and material prepared for a lawsuit sit outside the right itself. Many providers also have their own authorization form they prefer, especially when you're sending records to a third party. This letter works on its own and can also accompany theirs.

How long does a provider have to send my records?

Under HIPAA, a covered provider must act on your request within 30 days: give you the records, or give you a written denial. They can take one extension of up to 30 more days, but only if they tell you in writing why and when. Acting on the request is what the rule requires, so day 30 is a decision deadline rather than a guaranteed delivery date. The letter states this for you.

Can a provider charge me for my records?

A covered provider can charge a reasonable, cost-based fee. The rule lists what it may include: labor for copying, supplies, postage if you asked for it mailed, and preparing a summary you agreed to. Searching for and retrieving the records are not on that list. A per-page rate is allowed only where it reflects those actual costs, so a flat markup per page is worth questioning. One thing to know: that cap covers copies for you. When you direct records to a third party, a 2020 federal court ruling (Ciox Health v. Azar) removed the cap, and any state limit is what remains.

Can I request records for my child or my parent?

Yes, if you're their personal representative — a parent or guardian of a minor, a healthcare power of attorney, or an executor of the estate. Choose "I'm requesting for someone else" and the letter names your authority. The provider may ask for documentation of it.

What do I do after I send the letter?

Keep a copy and note the date you sent it, so you know when the 30-day clock runs out. When the records arrive — often as a stack of PDFs or a disc — you'll want one place to put them. That's exactly what KeptWell is for.

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Medical records request letter generator

Getting a copy of your medical records starts with asking the right way. Fill out the fields below and download a HIPAA-compliant records release/request letter, ready to print, sign, and mail or fax. It's free, it works for any provider, and nothing you type is saved.

Your right to your own records

You don't need a reason and you don't need anyone's permission. Under the HIPAA Privacy Rule (45 CFR 164.524), you have a legal right of access to a copy of your own medical records, what the rule calls your "designated record set." It applies to HIPAA covered entities, which is most doctors, hospitals, clinics, and health plans. They must act on your request within 30 days, may take one 30-day extension if they tell you in writing why and when, and may charge only a reasonable, cost-based fee covering copying labor, supplies, postage if you ask for it mailed, and any summary you agreed to.

The right has edges. Psychotherapy notes and material prepared for a lawsuit fall outside it, and access can be denied on the narrow grounds the rule lists, some of which you can have reviewed by another clinician. The fee limit covers copies for you: when you direct a provider to send records to someone else, a 2020 federal court decision (Ciox Health v. Azar, D.D.C.) took that limit off, so what a copy service charges a third party is governed by state law instead.

Sources, read on September 9, 2026: 45 CFR 164.524, the HHS right-of-access guidance, and the HHS notice on the Ciox court order. This is general information, not legal advice.

This letter puts that request in plain, correct language. If you're still tracking down where your records even live, our guide to finding old medical records walks through prior providers, closed practices, and health information exchanges. And if you're wondering whether the records still exist, here's how long providers keep them. Once the request is sent and the records are headed to a second opinion, here's how to track whether the second-opinion clinic received your records.

Requesting from a specific health system?

These pages explain exactly how each system handles record requests — the portal, the mailing address, the turnaround — with the letter above already pointed at the right place.

Records rules in your state

Your federal HIPAA right of access applies everywhere, and most states add their own copy-fee caps and response deadlines on top of it. Those state caps carry limits of their own: some cover only certain kinds of provider, some price electronic copies differently, and some do not apply when a third party is asking. Pick your state to see what applies, what it covers, and when we last read it.

Questions about requesting your records

Is this medical records request letter really free?: Yes. You fill out the form, download the PDF, and print or mail it — no account, no payment, no email required. We generate the letter and send it back to your browser; we don't save it or log anything you type.
Is this a HIPAA-compliant medical records release form?: The letter invokes your right of access under the HIPAA Privacy Rule (45 CFR 164.524), which lets you get a copy of your own records from a HIPAA covered entity: most doctors, hospitals, clinics, and health plans. A few record holders are outside HIPAA, and psychotherapy notes and material prepared for a lawsuit sit outside the right itself. Many providers also have their own authorization form they prefer, especially when you're sending records to a third party. This letter works on its own and can also accompany theirs.
How long does a provider have to send my records?: Under HIPAA, a covered provider must act on your request within 30 days: give you the records, or give you a written denial. They can take one extension of up to 30 more days, but only if they tell you in writing why and when. Acting on the request is what the rule requires, so day 30 is a decision deadline rather than a guaranteed delivery date. The letter states this for you.
Can a provider charge me for my records?: A covered provider can charge a reasonable, cost-based fee. The rule lists what it may include: labor for copying, supplies, postage if you asked for it mailed, and preparing a summary you agreed to. Searching for and retrieving the records are not on that list. A per-page rate is allowed only where it reflects those actual costs, so a flat markup per page is worth questioning. One thing to know: that cap covers copies for you. When you direct records to a third party, a 2020 federal court ruling (Ciox Health v. Azar) removed the cap, and any state limit is what remains.
Can I request records for my child or my parent?: Yes, if you're their personal representative — a parent or guardian of a minor, a healthcare power of attorney, or an executor of the estate. Choose "I'm requesting for someone else" and the letter names your authority. The provider may ask for documentation of it.
What do I do after I send the letter?: Keep a copy and note the date you sent it, so you know when the 30-day clock runs out. When the records arrive — often as a stack of PDFs or a disc — you'll want one place to put them. That's exactly what KeptWell is for.

What we will never do with your records

This generator runs without an account, and KeptWell itself makes the same promises to every family, regardless of plan or price.

We won't sell your data.: Not to advertisers, not to data brokers, not to insurers, not to pharma, not to anyone, in any form, ever.
We won't train AI models on your records.: KeptWell does not opt in to model training. OpenAI and Anthropic do not use API inputs or outputs to train their models by default.
We won't lock you in.: You can export everything in your circle as a ZIP at any time. Cancellation is one click.

Read the full data practices →

You just asked for your records. KeptWell is where they land.

Upload them the moment they arrive — a stack of PDFs, a disc, a fax — and KeptWell reads each one, organizes it, and lets your whole family ask questions about it. It's the digital medical record organizer that does the organizing. Free today.

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More on the product: how it works, the medical record organizer, pricing, and what we do with your data.