How to use this worksheet
Use it to organize facts and documents before an attorney review. It does not determine whether malpractice occurred and should not delay medical care or urgent legal advice about a deadline.
Medical Records Request tasks
- ☐ List each facility, physician group, imaging center, laboratory, and pharmacy involved.
- ☐ Request the complete designated record set rather than only portal summaries.
- ☐ Ask separately for imaging files when they are not included with radiology reports.
- ☐ Request itemized billing records and EOBs if damages are being evaluated.
- ☐ Track request date, method, response date, and missing date ranges.
- ☐ Save all records in original form and make a separate working copy.
- ☐ Do not write notes on originals.
- ☐ Follow HHS guidance if access is delayed or denied.
Tracking table
| Item | Date requested / completed | Source | Notes |
|---|---|---|---|
| 1 | |||
| 2 | |||
| 3 | |||
| 4 |
Keep sensitive information private
Do not place Social Security numbers, account passwords, full medical-record sets, or other unnecessary sensitive data into a worksheet that might be emailed or shared casually. A lawyer can tell you what documents are appropriate to send.
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Reliable starting sources
Use primary or authoritative sources for medical records, legal definitions, licensing, and state-specific rules. General pages cannot calculate a filing deadline or decide whether malpractice occurred.