Medical Records Health Information Management Manual

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5039 - Response to Subpoena Duces Tecum Form

About this Document

5039 - Response to Subpoena Duces Tecum Form is one of many policies and procedure templates within Medical Records Health Information Management Manual written for the medical office, hospital, and other healthcare organizations. The policies cover: Joint Commission (JCAHO or TJC) • CMS • HIPAA • CDC • AAAHC and more.

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Sample Content From 5039 - Response to Subpoena Duces Tecum Form

Snippets are randomly selected, unformatted passages from the Microsoft Word policy template.

Snippet

RE: Response to Subpoena Duces Tecum
Dear ____:
On (date) ____, we received the civil subpoena duces tecum you caused to be
issued or served in connection with the case of (plaintiff) ____ v.
(defendant) ____, case number ____.
You asked that the medical records of (name of patient) ____ be produced
pursuant to this subpoena.
However, we have noted that the subpoena duces tecum does not comply with the following applicable
statutory provision(s):
(check all that apply)

Second Snippet

The subpoena duces tecum was not served together with a supporting affidavit (i.e., Application for
Subpoena Duces Tecum or Application for Subpoena Duces Tecum Re Deposition).