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. Many providers also have their own authorization form they prefer you use, 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 provider must act on your request within 30 days. They can take one extension of up to 30 more days, but only if they tell you in writing why and when you'll get the records. The letter states this for you.

Can a provider charge me for my records?

They can charge a reasonable, cost-based fee — the actual labor of copying plus postage — not a per-page markup or a search fee. Electronic copies of electronic records are often free or close to it. If a fee seems high, you can push back.

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." A provider must act on your request within 30 days, can take one 30-day extension only with written notice, and can charge only a reasonable, cost-based fee for copying and postage.

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.

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, but most states add their own copy-fee caps and response deadlines on top of it. Pick your state to see what applies and get the letter pointed at the right rule.

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. Many providers also have their own authorization form they prefer you use, 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 provider must act on your request within 30 days. They can take one extension of up to 30 more days, but only if they tell you in writing why and when you'll get the records. The letter states this for you.
Can a provider charge me for my records?: They can charge a reasonable, cost-based fee — the actual labor of copying plus postage — not a per-page markup or a search fee. Electronic copies of electronic records are often free or close to it. If a fee seems high, you can push back.
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.: Anthropic (whose Claude model powers KeptWell) is contractually prohibited from training on anything we send them, under a signed Business Associate Agreement.
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.