Request Records from Dentist

Write this type of letter when you are asking your dentist to send your records from your care at their office. You will typically ask them to send the records directly to you or to another dentist. If you want them to send the records directly to another dentist, specify the address, email address, or fax number to which they should send the records.

[Your letterhead, if desired; if not, your return address]

[Date of letter-month, day, and year]

[Recipient's first and last names]
[Company name]
[Street or P.O. box address]
[City, State ZIP code]

Dear [recipient's name]:

I have been a patient at your dental office from 2006 until the present. As of next month, I will begin my dental care at the offices of Seaside Dental. As soon as possible, please send all of my dental records, including x-rays, to the following address:

Seaside Dental
767 Harborside Drive
North Beach, SC 27563

Please do not hesitate to contact me at 231-0055 if you have questions about this. Thank you for your office's attentive dental care.

Sincerely,

[Signature]

[Sender's first and last names]