Free template: Release of Information request tracker

What is inside

The template has 17 columns built around the four states a records request can be in — pending intake, needs cure, in fulfillment, released — and the day-by-day routine that keeps you inside the HIPAA 30-day window. The "days remaining" column is a formula so you can sort by overdue at a glance.

The columns

• Request # — Your internal tracking number.
• Date received — When it arrived (not when it was logged). The HIPAA clock starts here.
• Requester name + type — Patient, attorney, payer, disability, continuity-of-care, subpoena. Sliceable for reporting.
• Patient name + DOB — For matching to the chart.
• Records scope — Date range or specific records. This is the source of over-release / under-release errors; document it precisely.
• Authorization valid? — Yes / No / Pending. If pending, the request is in "needs cure" state.
• Custodian + Approver — Who pulls the records, who approves the release. Separation of duties matters for the audit trail.
• HIPAA due date (day 30) — Calculated from the date received. Set as a formula or hard date.
• Days remaining — A formula that counts down. Negative = overdue. Use conditional formatting to flag red at <5 days.
• Status + Date released + Delivery method + Audit notes — The release record.

How to use it

1. Download the CSV. Open in Excel or Google Sheets.
2. Log every records request the same day it arrives. The HIPAA clock starts the date received, not the date entered.
3. Sort by "Days Remaining" ascending. Anything at zero or negative is at risk.
4. Retain the register for 6 years per HIPAA. Do not overwrite — copy to a new sheet each year and archive.
5. When the spreadsheet stops working (volume, multi-site, or audit asks for tamper-evident proof), graduate to RCMTask's Release of Information module.