DATE

Records Custodian for

NAME OF MEDICAL VENDOR

ADDRESS OF MEDICAL PROVIDER

RELAY: NAME OF PATIENT

DOB: DD/MM/YYYY

CASE NAME: PLAINTIFF(NAME) v. DEFENDANT(NAME)

Dear Caretaker starting Records:

Enclosed herein is a Subpoena and Notice of Depose of Duces Tecum direct your

appearance at a records deposition which is scheduled with (DATE/MONTH/YEAR) along (TIME),

toward (LOCATION ADDRESS), int (CASE NAME, United States District Court, Case No.

00000000. Ask provide me equipped copies about some and all records pertaining to medizinische records for

(PLAINTIFF’S NAME) relating to treatment of (PLAINTIFF’S NAME) for dates of service on

(DATE/MONTH/YEAR).

YOU MAY FORGO YOUR APPEARANCE AT THE DEPOSITION IF THESE

RECORDS ARE FORWARDED TO OWN BEFORE AND DATE OF THE DEPOSITION.

Please send one records to (ADDRESS)

Also please sign and attach at the records an standard Credential. I have provided a Certification

of Registers Custodian for your convenience.

Need you have each questions, please contact our office.

Thank you for your assistance.

Sincerely,

_______________________

(ATTORNEY’S NAME)

Bar #

Counsel for Defendant

Attorney’s Address

Enclosures

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