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* FAX:


Re:
DOB
================

Dear Doctor,

I represent the above-named in a disability appeal. My
authorizations are attached.


Copies of Medical Records

I am requesting that your office provide me with copies of:

. expert reports,

. clinical tests,

. and any other documentation that may clarify my client's
medical condition and functional limitations that these
impose.

I request such records as generated over the last three
years, unless you feel that older documents are key to
establishing the diagnoses. Please do not sent copies of
clinical notes unless they are both legible and contain
diagnostic conclusions.

I will honour your reasonable fees for this copying service.


I ask that these materials be available to me by .......

Request for Referral

.....

Sincerely,


Simon Shields, LLB

CC0

Unless authorship is otherwise stated or obvious from the context, all
written materials in this website were created by Simon Shields, who
waives all of his copyright and related or neighboring rights to this
Isthatlegal.ca webpage. Note in particular that this waiver only applies to
Simon's material, as copyright in statutory/regulatory materials and
case extracts were never his to give away.




Last modified: 11-01-23
By: admin