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Claude Prompt: Build Chronological Medical Treatment Summary for PI Demand Letters

Convert messy medical records into a clean dated treatment narrative ready to drop into a demand letter or trial binder exhibit.

The Prompt

claude prompt
4: Chronological Medical Treatment Summary

Create a chronological medical treatment summary for litigation purposes. Organize the following treatment records into a clear, dated narrative format suitable for inclusion in a demand letter or trial binder.

Patient: [Client Name]
Date of accident: [date]
Pre-existing conditions: [list any relevant prior conditions, or "None documented"]

Treatment records (list each visit):
- [Date]: [Provider name], [Type of visit]. Findings: [key findings]. Diagnosis: [diagnoses]. Treatment: [what was done]. Follow-up: [recommendations].
[Repeat for each visit]

For each entry, note:
1. Subjective complaints reported by the patient
2. Objective findings by the provider
3. Diagnoses or diagnostic impressions
4. Treatment provided
5. Referrals or follow-up recommendations
6. Any causal language linking complaints to the accident

At the end, provide a summary section that includes:
- Total number of treatment visits
- Total duration of treatment
- List of all diagnoses
- List of all providers
- Any gaps in treatment with suggested explanations
- Overall trajectory of recovery (improving, stable, worsening)

Variables (7)

VariableDescriptionExample
{{client_name}}Client NameMaria Gonzalez
{{provider_name}}Provider NameDr. Andrew Lee, Pacific Orthopedics
{{type_of_visit}}Type of VisitInitial consultation
{{key_findings}}Key FindingsTenderness at C5-C6, reduced cervical ROM, positive Spurling's test.
{{diagnoses}}DiagnosesCervical disc herniation C5-C6; lumbar strain.
{{what_was_done}}Treatment ProvidedPrescribed muscle relaxant; ordered cervical MRI.
{{recommendations}}Follow-up RecommendationsBegin PT 2x/week for 6 weeks; reassess in 4 weeks.

Expected Output

A dated, visit-by-visit treatment narrative with subjective/objective findings, diagnoses, providers, gap explanations, and a recovery trajectory summary.

Usage Notes

Run on Claude Sonnet 4.5+ for best clinical reasoning. Always feed the model raw record excerpts rather than your interpretation, and instruct it to flag any entry where it cannot verify a date or diagnosis to avoid hallucinated findings.

Originally featured in: AI for Personal Injury Lawyers: Prompts for Demand Letters, Medical Summaries & Depositions

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