How to Get a Copy of Your Therapy Notes and Mental Health Records

What records can I actually access?

Under HIPAA's right of access (45 CFR § 164.524), you have the right to inspect and receive a copy of your "designated record set" — the clinical information that informs your care 1Ref 1U.S. Department of Health and Human Services (2023).Individuals' Right under HIPAA to Access their Health Information — 45 CFR § 164.524.Patients have a right of access to their designated record set under 45 CFR 164.524; psychotherapy notes (private notes separate from the clinical record) are excluded from this right; providers have 30 days to respond with one 30-day extension permitted. For behavioral health, this typically includes:

• Progress notes (the official session-by-session clinical record)
• Intake assessments and evaluations
• Treatment plans and diagnoses
• Medication records, if your prescriber is at the same practice
• Referral letters and discharge summaries
• Billing records

The important carve-out is what HIPAA calls psychotherapy notes — defined narrowly as the private notes a therapist writes for their own use during or after a session, separate from the formal clinical record 1Ref 1U.S. Department of Health and Human Services (2023).Individuals' Right under HIPAA to Access their Health Information — 45 CFR § 164.524.Patients have a right of access to their designated record set under 45 CFR 164.524; psychotherapy notes (private notes separate from the clinical record) are excluded from this right; providers have 30 days to respond with one 30-day extension permitted. Providers are not required to release these even if you ask. Most of what ends up in your chart is not psychotherapy notes by this legal definition, so the right to access applies to the bulk of your record.

How do I make a records request?

Contact the provider's office — by phone, email, or the patient portal — and ask for a "Records Release" or "Authorization to Release Medical Records" form. You will typically need to specify:

• The records you want and the date range
• Where they should be sent (to you, to a new provider, or both)
• Your identity verification (most forms require a photo ID)

Under HIPAA, providers generally have 30 days to respond to a records request, with a one-time extension of another 30 days allowed for complex requests 1Ref 1U.S. Department of Health and Human Services (2023).Individuals' Right under HIPAA to Access their Health Information — 45 CFR § 164.524.Patients have a right of access to their designated record set under 45 CFR 164.524; psychotherapy notes (private notes separate from the clinical record) are excluded from this right; providers have 30 days to respond with one 30-day extension permitted. They may charge a reasonable copying and processing fee, though many providers waive it 2Ref 2HHS Office for Civil Rights (2023).Individuals' Right under HIPAA to Access their Health Information (Patient FAQ).Patients can file complaints with HHS OCR at no cost when HIPAA access rights are violated; providers may charge a reasonable fee but cannot use cost as a barrier to access.

If your provider uses an electronic health record with a patient portal, some records may be accessible online without a formal written request.

What if my request is denied or delayed?

If records are withheld, the provider must tell you what is being withheld and why. If you believe your rights are being violated, you can:

• Ask the practice's Privacy Officer to review the decision
• File a complaint at no cost with the U.S. Department of Health and Human Services Office for Civil Rights (OCR) 2Ref 2HHS Office for Civil Rights (2023).Individuals' Right under HIPAA to Access their Health Information (Patient FAQ).Patients can file complaints with HHS OCR at no cost when HIPAA access rights are violated; providers may charge a reasonable fee but cannot use cost as a barrier to access

State laws sometimes provide stronger protections than HIPAA — California, New York, and other states have additional mental health privacy provisions. Your state health department or an attorney can clarify your specific rights.

Are there special situations that change the process?

A few circumstances affect how the standard rules apply 3Ref 3U.S. Department of Health and Human Services (2022).HIPAA Privacy Rule and Sharing Information Related to Mental Health.Guidance on HIPAA rules specific to mental health information, including the psychotherapy notes exception and situations where state law provides stronger protections:

Minors and guardians. Parents or guardians generally have access to a minor's records, but many states give adolescents independent privacy rights around behavioral health care. Rules vary significantly by state and age.

Deceased individuals. Authorized personal representatives — such as an estate executor — generally have access under HIPAA, though additional documentation is usually required.

Closed or relocated practices. If your provider has closed, contact your state medical or licensing board for guidance on where records were transferred.

Hospital or health system records. If your care was within a larger system, the request goes through the system's medical records department rather than an individual clinician.