Request To View Records

Katherine Brothers 567-45-8587 10/29/62 205 West 14th Street Merced CA 95340 209-261-0008 DOS 05/20/09 and 06/16/09 This is regarding the above patient and this letter is from the patient dictated to family member. REQUEST FOR PATIEN ACCESS TO MEDICAL RECORDS I hereby request University Surgery Center to provide me access to my personal records. SCOPE OF ACCESS REQUESTED I would like access to all signed releases relating to surgeries performed on 05/20 and 06/16/09 for Carpal Tunnel Surgery performed My Dr. Vanek. COPIED OF RECORDS I don't believe I copies will be necessary however I will provide my own copier and paper so there will be no charge to your office at all. Please call me within 7 days of the date of this request to set up a convinient time and date so that I can come to your office to view my records. You may call me anytime at 209-261-0008 Thank you, Katherine Brothers