The problem is most patient's don't think ahead. Sometimes it's not a referral, sometimes it's just a patient going for a second opinion, or an IME for an insurance claim. Sometimes they want records for themselves or an attorney for a lawsuit. They tend to get notification of whatever it is and wait until the day before to call and say they need their records. Then get huffy when they find out there are regulations. Sure, if the patient were in the doctor's office they could sign a form at that time, but it's not always thought about. I'm not saying the patient needs to know everything, but I don't act like they're stupid. I explain what is needed, and often why, and they still get huffy. I had to get my records when I was pregnant. I signed the authorization form, and had to wait 10 days before my records came in just like anyone else. It's just the way it is. I just don't see the hardship in signing your name on a form to get copies of your medical records.