Medical Records Request Log

Who this is for

A log of every request you make for copies of your own records. Each line records who you asked and when, what you asked for, how you sent it, when they came back, how long that took and what actually arrived — so a request that goes unanswered is visible rather than forgotten.

Anyone gathering their records for a new practice, a claim, a second opinion or a move abroad, relatives requesting records on somebody's behalf, and people who have asked once already and heard nothing.

What this helps you track

• Every request with the date it went and who it went to
• Exactly what was asked for, so a partial reply is obvious
• How it was sent, and any reference number you were given
• The date of the reply and the days in between
• What arrived, what is still missing and any fee paid

How to use it

1. Write your details and the reason you are gathering records at the top of the sheet.
2. Put in a row the day a request goes, with the name of the practice, hospital or department and the exact wording of what you asked for.
3. Note how you sent it — form, letter, email, portal, in person — and any reference you were given.
4. Fill in the response date when something comes back; the days column counts the wait between the two dates.
5. Say in the outcome column what actually arrived, and tick complete only when you have everything you asked for.
6. Chase the open rows and add a note with the date and the name of whoever you spoke to.

Formats

• Printable PDF (A4 and US Letter)
• Fillable PDF with form fields
• Fill in online, saved in your browser
• Excel / Google Sheets workbook

The printable is laid out inside a box that fits both A4 and US Letter, so the two files are identical and neither one is scaled. The fillable PDF has real form fields. The workbook uses plain formulas only — SUM, IF, COUNTIF and the like — so it opens in Excel, LibreOffice and Google Sheets without anything breaking, and every calculated cell is grey so you can see which figures it worked out.

How to print

Download the A4 or US Letter file to match the paper in your printer, open it in a PDF reader and print at 100% — not "fit to page", which shrinks the writing space. Both files leave a 14 mm margin, which clears the unprintable edge on home printers. To print the online version with your entries in it, use the Print this sheet button, which prints only the sheet and none of the page around it. More on printing.

Questions

Does the sheet say what I am entitled to ask for?

No. The rules about access to records differ from one country to another, so check where you are. This sheet records what you asked, who you asked and what came back, and nothing else.

Why write down exactly what I asked for?

Because replies are often partial. Unless the wording of the request is on the page, it is very hard to show later that half of what you asked for never arrived.

What is the fee column for?

Whatever you were actually charged, where anything is charged. No figure is supplied anywhere on the sheet; it simply totals what you enter.

Should I log requests made by phone?

Yes, and note the name of the person you spoke to and the date. A telephone request with a name against it is far easier to follow up than one nobody remembers.

Can I use it for records held in another country?

Yes. The sheet has no jurisdiction built into it and no assumption about who holds what — it is a dated list of requests and replies, wherever they are going.