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SKILL.md
Medical Records Request Skill
Your medical records are, in most places, yours by right — and yet getting them can feel like a heist: unanswered faxes, "we only send to other doctors," fees that materialize, imaging reports sent without the images. The gap is almost never law; it's process friction that a specific, itemized, deadline-aware written request cuts straight through. This skill writes that request, decodes the format choices that matter (images vs. reports, portal vs. complete file), and ladders the follow-up for offices that need reminding.
What This Skill Produces
The itemized request letter — specific records, date ranges, format, delivery, ready to send
The what-to-ask-for decode — the difference between the portal view, the "designated record set," imaging images vs. reports, and pathology materials — matched to the user's purpose
The follow-up ladder — polite check → written reminder citing timelines → complaint paths, with dates
The personal health-file structure — how to keep what arrives so the next request is smaller
Required Inputs
Ask for these if not provided:
The purpose — second opinion, new doctor, moving, personal archive, dispute — it determines which records and what format (a consultant needs images; a new PCP needs the summary and problem list)
The providers involved — each holds its own records; hospital systems and imaging centers are separate requests from the physician's office
The jurisdiction, loosely — access rights, response timelines, and permissible fees vary by country/state; the letter cites rights generically with a verify-locally flag, and the user can look up specifics
Any deadline — an appointment date turns the request urgent and belongs in the letter
Framework: The Friction-Cutting Rules
Itemize or receive a summary: "my records" gets you a visit summary; the letter names each item — clinic notes [date range], lab results, imaging reports and images on disc/transfer, pathology reports (and slides if a consult needs them), medication list, referral letters. Specificity is the whole trick.
Put it in writing, address it to the records custodian: verbal requests evaporate; the letter creates the clock. Ask the office which channel (portal message, form, fax — yes, still fax) counts as their official intake, then use it and keep proof of the date.
You, not just your doctors: records offices sometimes claim patient copies aren't available or only provider-to-provider transfer exists — in most jurisdictions patients have direct access rights; the letter's rights sentence (kept generic, flagged verify-locally) exists for exactly this deflection.
Fees and timelines have rules: most jurisdictions cap copying fees and set response windows. The letter asks for the fee schedule up front and notes the request date; the follow-up ladder cites the elapsed time, not outrage.
The purpose sets the format: consults need source materials (images, slides); continuity needs the summary set; archives want the complete designated record set once, then incremental updates. Over-requesting has a real cost — a 900-page complete file for a routine handoff buries the signal.
Output Format
Records Request: [providers] — purpose: [purpose]
The Letter
[Ready to send: patient identifiers · itemized records with date ranges · format and delivery choices · the generic access-rights sentence (verify-locally flagged) · fee-schedule request · the deadline if real · date and signature line]
What You're Asking For, Decoded
Item
Why this format
Common pitfall
The Follow-Up Ladder
Day 0: send via official intake, keep proof · Day ~10: polite status call, note the name · Day ~20: written reminder citing elapsed time and the request date · Beyond the local window: the complaint paths (records custodian's supervisor, the practice manager, and the applicable regulator — named as types, jurisdiction-flagged)
The Health File
[Structure for what arrives: by provider then date · the running summary page · what to hand the next new doctor — so this request is the last big one]
Access rights, timelines, and fee caps are jurisdiction-specific and change — verify the local specifics before citing exact numbers; this skill's letters cite rights generically for exactly that reason.
Quality Checks
The letter itemizes records with date ranges — no bare "all my records" unless the purpose is a true archive
Imaging images vs. reports is explicitly chosen per the purpose
The rights sentence stays generic with the verify-locally flag — no invented statute citations
The ladder runs on dates and elapsed time, not temperature
Each provider/facility gets its own request — one letter to the hospital doesn't fetch the imaging center's files
Anti-Patterns
Do not cite specific statutes, fee caps, or day-counts as fact — jurisdictions differ; generic rights + verify-locally is the honest letter
Do not accept "we only send provider-to-provider" silently — the direct-access sentence exists for this
Do not over-request — format follows purpose; the complete file is for archives, not handoffs
Do not escalate before the clock has actually run — the ladder's power is its reasonableness
Do not interpret the records' medical content — organize the paper; the medicine belongs to clinicians
