Documents › Formats › Authorization letters
Hospitals release reports and records only to the patient or an authorised person, because of patient confidentiality. Insurance claims, second opinions and visa medicals often need someone else to collect the documents while the patient is unwell or away.
To, The Medical Records Department, Lakeshore Hospital, Kochi.
Subject: Authorization to collect my medical records — UHID 123456, IP No. 2026/7890
I, Mohammed Rafi, son of Abdul Khader, residing at Rafi Manzil, Kottakkal, Malappuram 676503, was admitted to your hospital from 10 to 16 October 2026 under Dr. Anu Mathew.
I authorise my son, Mr. Shamil Rafi, holding Aadhaar no. XXXX XXXX 3456, to collect on my behalf the discharge summary, all investigation reports, the itemised bill and the MRI films relating to the above admission, which are needed for my health-insurance claim. He may sign the records-release acknowledgement.
Copies of my Aadhaar card and his Aadhaar card are enclosed. This authorisation is valid for 30 days.
Names, numbers and dates above are examples. Replace them with yours.
No stamp paper. Hospitals have a records-request form; attach this letter to it. If the patient cannot sign (ICU, unconscious), the next of kin signs a declaration instead, and the hospital may ask for proof of relationship.
No. Under the Indian Medical Council regulations, patients are entitled to their records within 72 hours of request. Case sheets of deceased patients go to the legal heir.
Collect originals of bills and reports; keep photocopies with hospital seal for yourself.
Same letter, addressed to the lab, with the lab's reference number.
This page is a template and general guidance for a common situation, not legal advice. Rules differ by state and office; check with the office that asked for the document. Last reviewed October 2026.