Records requests to every provider, in one pass.

Enter the patient and the providers once. Get a HIPAA-style records-request letter for each provider, batched into a single download.

Patient name *

Patient date of birth *

Matter / file number *

Date of service — from *

Date of service — to *

Authorization reference

Providers *

One row per provider. Each becomes its own letter to that provider's records custodian.

Your firm supplies the signed authorization.

Each letter references a HIPAA authorization the patient has signed and that your firm sends under separate cover. This tool drafts the request letters; it does not create or send the authorization.

Output is a DRAFT for demonstration only — not legal advice. Attorney/paralegal review required.