[Name & Address] Dear [Title & Name]:
We are in receipt of the following legal request issued from your office on [Date] and directed to [Recipient Name] regarding [Patient Information/Items/Records Requested]:
q Subpoena Duces Tecum
q Deposition Request
q Court Order
Please be advised that [Recipient Name (or Organization Name if appropriate)] is unable to comply with the request set forth in this legal request for the following reasons:
q The organization has no records available in response to the Legal Request.
q The organization requires greater specificity regarding the Legal Request.
q The organization has no records available for the patient identified in the Legal Request.
q The organization has no records available related to the information requested in the Legal Request.
q The recipient named in the Legal Request is not a member of the organization's workforce.
q The business entity or facility named in the Legal Request is not a part of the local organization (Ministry Health Care facilities do not accept Legal Proceeding Requests on behalf of other Ministry Health Care facilities).
q The Subpoena/Subpoena Duces Tecum/Deposition Request is not accompanied by a patient authorization (required by HIPAA and Wisconsin Law).
q The Subpoena/Subpoena Duces Tecum/Deposition requires other authorization.
q The Subpoena/Subpoena Duces Tecum/Deposition Request is not signed by a judge (court-ordered).
q The Subpoena/Subpoena Duces Tecum/Deposition Request is not valid due to:
q The legal document was not served appropriately (e.g., fax, mail, etc.) and/or in a timely manner allowing a reasonable time for response.
q The organization is currently working with legal counsel to Quash the legal document [provide name of legal counsel involved].
q Other: .
If you have questions or concerns, please do not hesitate to contact me. Sincerely,
[Insert Name/Contact Information]