- Form
Sample Denial Letter of Patients' Request to Amend Medical Record
Our sample denial letter for medical record amendment requests can be downloaded and customized for use at your medical practice.
This sample denial letter offers guidance to respectfully deny patient requests for amendments to their medical records while remaining compliant with their right to amend their protected health information.
This sample letter is for general informational purposes to help you create a customized letter that fits your practice. This sample should not be considered as legal advice. Please consult with an attorney to ensure compliance with state laws, rules, and regulations surrounding amending medical records. You can download and customize this form. Be sure to complete the highlighted fields with your practice-specific information.