Model Patient Request for Health Information Form Issued by AHIMA

A model patient request for health information form has been issued by the American Health Information Management Association (AHIMA) that can be used by healthcare providers to give to patients who request copies of their health information.

The HIPAA Privacy Rule permits patients to obtain copies of their health data from their providers, although at many hospitals the process is inefficient, lacks transparency and patients are often left in the dark about what is happening after they have submitted their requests, according to a recent report from the ONC.

Under HIPAA Rules, patients must be provided with copies of their health information within 30 days of the request being submitted. Patients are also permitted to request their information in paper or electronic form, although ONC points out patients are often confused about timescales and how information can be provided. That confusion often prevents patients from exercising their rights to obtain their health data.

The patient request for health information forms used at many hospitals do not help matters. The forms can be confusing and, until now, there has been no standard form for healthcare providers to use.

Providers that adopt AHIMA’s model patient request for health information form can be sure they are compliant with HIPAA Rules and it is hoped the form will make PHI requests easier for providers and patients alike.

While the patient request for health information form has been created to be applicable for use by the widest range of healthcare providers, it can also be used as a template and healthcare providers can modify the form as necessary. They can add their own logos and barcodes and tailor the form to match their system capabilities, such as detailing the formats that PHI can be provided in.

Many healthcare organizations struggle to meet the 30-day deadline as the process of providing records is inefficient. It is hoped that the form will help healthcare providers to meet the HIPAA deadline and provide health information to patients much more quickly.

The form is written in easy-to-understand language making it easier for patients, while all the appropriate information is collected in a standard format making it easier for healthcare organizations to process requests. While the form is HIPAA-compliant, AHIMA suggests providers should consult 45 CFR 164.524(c)(3), especially if the patient request for health information form is modified.

HIMA interim CEO Pamela Lane, MS, RHIA, said, “AHIMA is committed to promoting and advocating for best practices in health information and to ensuring patients have access to trusted health information,” Lane went on to say, “Our hope is that it will help connect patients with their health information and make them more empowered healthcare consumers.”

Author: Richard Anderson

Richard Anderson is the Editor-in-Chief of