HIPAA Right of Access Request Generator
HIPAA Right of Access Request Generator - a deterministic tool in Sophie Well's Insurance & Patient Literacy group.
Open the HIPAA Right of Access Request Generator → Runs in your browser. No signup, no tracking.
What this is
Generate a printable HIPAA Right of Access request letter that a patient can send to a covered entity to obtain a copy of their own medical record. The HIPAA Privacy Rule at 45 CFR 164.524 gives every individual the right to inspect and copy their designated record set, with a 30-day response deadline (extendable by one additional 30 days with written notice), a cost-based fee cap, and the right to designate a format and a delivery destination. Sophie Well fills the patient's name, the covered entity, the record range, and the requested delivery format into a complete letter ready to print and sign.
When to use it
Use this when you need a paper trail that triggers the 30-day clock under federal law, when a provider has been informally ignoring verbal record requests, or when a patient needs records sent directly to a third party (a new provider, an attorney, a research project) under the third-party-designation right. The generated letter cites 45 CFR 164.524, names the deadline explicitly, and frames the fee limit so the receiving release-of-information office cannot quote per-page rates above the cost-based cap. This is reference assistance, not legal advice; for an enforcement complaint, the patient files with the HHS Office for Civil Rights.
References
HIPAA Privacy Rule, 45 CFR 164.524. Right of Access; 30-day response requirement with one 30-day extension; cost-based fee cap.
Worked example: Click "Build printable request" to render a 45 CFR 164.524 letter citing the 30-day response requirement and the cost-based fee cap.
Sophie Well is a reference and educational tool. Not medical, legal, or financial advice. Does not replace clinician judgment, professional billing review, or legal counsel.