Subpoena Duces Tecum Sample for Personal Injury Cases 

Quick answer: A subpoena duces tecum is a court order. It tells a person or a company to hand over records. In an injury claim, lawyers use one to get medical files, bills, and reports. A good subpoena duces tecum sample has four parts. It has a case caption. It has a clear list of records. It has a due date. It also includes a signed proof of service.

Subpoena Duces Tecum Sample: Full Model Text

Most sites hide the sample behind a paywall. This page does not. Here is the full document subpoena sample you can adapt today.

Federal sample (Form AO 88B format)

Use Form AO 88B in federal court. It is the official records subpoena form for civil cases. The form commands you to produce papers, electronic files, or objects at a set time and place. It also lets the other side copy, test, or sample those items.

UNITED STATES DISTRICT COURT

for the Central District of California

JANE DOE,

Plaintiff,

v.

JOHN ROE and ACME TRUCKING,

Defendants.

Civil Action No. 2:26-cv-00000

SUBPOENA TO PRODUCE DOCUMENTS,
INFORMATION, OR OBJECTS

(Form AO 88B)

TO:

Custodian of Records
Valley General Hospital
100 Main Street
Los Angeles, CA 90001

YOU ARE COMMANDED to produce, at the time, date, and place set forth below, the documents listed in Attachment A.

PLACE: Smith Law Group 200 Oak Ave. Los Angeles, CA 90002
DATE AND TIME: October 15, 2026, at 10:00 a.m.

The provisions of Fed. R. Civ. P. 45(c), (d), (e), and (g) are attached.

DATE: September 10, 2026

/s/ Maria Smith

Maria Smith
Attorney of Record for Plaintiff
State Bar No. 000000
(213) 555-0100
info@thehadilawfirm.com

That last block is your attorney of record signature block. The line above it is your case caption and civil action number. Both must match the court file exactly.

California sample (SUBP-010 and SUBP-020 format)

California uses Judicial Council Form SUBP-010 for a records-only request. This is the deposition subpoena for production of business records. Use Judicial Council Form SUBP-020 when you also want the person to show up and talk.

People mix these two up all the time. One guide warns that clerks reject older versions of the form, so always check the revision date on the state site before you file.

DEPOSITION SUBPOENA FOR PRODUCTION OF BUSINESS RECORDS

(Judicial Council Form SUBP-010)

Superior Court of California
County of Los Angeles

Plaintiff: JANE DOE Defendant: JOHN ROE
Case Number: 26STCV00000

THE PEOPLE OF THE STATE OF CALIFORNIA, TO:

Custodian of Records
Valley General Hospital
100 Main Street
Los Angeles, CA 90001

YOU ARE ORDERED to produce the business records described in Item 3 to the deposition officer named in Item 4.

Date: October 15, 2026
Time: 10:00 a.m.

2. The records are to be produced by (check one):

[X] Delivering a true, legible, and durable copy with the
affidavit under Evidence Code section 1561.

3. The records to be produced are described in Attachment 3.

4. Deposition officer:
ABC Copy Service, PSR #1234

DISOBEDIENCE OF THIS SUBPOENA MAY BE PUNISHED AS CONTEMPT.

YOU WILL ALSO BE LIABLE FOR THE SUM OF $500 AND ALL DAMAGES
RESULTING FROM YOUR FAILURE TO OBEY.

Item 4 is your deposition officer designation. Most firms name a professional photocopy service here.

Texas sample (Rule 176 format)

Texas has no statewide fill-in form as California does. You draft your own. But Texas Rule of Civil Procedure 176 tells you exactly what must go in it.

Three rules shape the Texas draft. First, every subpoena must be issued in the name of “The State of Texas”. Second, a Texas-licensed attorney may issue and sign it as an officer of the court, so no judge is needed. Third, the paper must carry the contempt warning from Rule 176.8(a).

CAUSE NO. DC-26-00000

JANE DOE,

Plaintiff,

v.

JOHN ROE and ACME TRUCKING,

Defendants.

§ IN THE DISTRICT COURT

§

§ DALLAS COUNTY, TEXAS

§ 191st JUDICIAL DISTRICT

SUBPOENA DUCES TECUM

THE STATE OF TEXAS

TO: Custodian of Records, Baylor Regional Medical Center, 100 Main Street, Dallas, Texas 75201

YOU ARE COMMANDED to produce and permit inspection and copying of the documents described in Exhibit A, which are in your possession, custody, or control.

Place: Smith Law Group
200 Oak St.
Dallas, TX 75202
Date and Time: October 15, 2026, at 10:00 a.m.

This subpoena is issued at the instance of Plaintiff Jane Doe, whose attorney of record is Maria Smith.

You may comply by delivering legible copies with a business records affidavit under Texas Rule of Evidence 902(10). If you do, you need not appear in person.

NOTICE: Failure by any person without adequate excuse to obey a subpoena served upon that person may be deemed a contempt of the court from which the subpoena is issued and may be punished by fine or confinement, or both.

(Tex. R. Civ. P. 176.8(a))

Issued on September 10, 2026.

/s/ Maria Smith

Maria Smith, Attorney of Record for Plaintiff
State Bar No. 00000000 | (214) 555-0100

Note the money rule. In Texas, no fine or attachment may be issued unless the requesting party swears by affidavit that all witness fees due by law have been paid or tendered. So tender the fee, then keep the receipt.

Texas Rule 205.3 notice to nonparty

Texas has its own version of the consumer notice. You cannot just fire off the subpoena. Under Rule 205.2, you must serve a notice to produce documents at least 10 days before serving the subpoena compelling production.

That gap exists for a reason. One practice treatise explains that, without the wait, a records clerk might hand over the files right away just to be done, depriving the other parties of their chance to move for protection.

A second timing rule also applies. Both the notice and the subpoena must go out no later than 30 days before the end of the discovery period.

NOTICE OF INTENT TO SERVE SUBPOENA DUCES TECUM

ON NONPARTY (Tex. R. Civ. P. 205.2 and 205.3)

TO: All parties of record and the nonparty named below.

PLEASE TAKE NOTICE that on or after September 22, 2026, Plaintiff will serve a subpoena on:

Custodian of Records
Baylor Regional Medical Center, Dallas, Texas

commanding production at Smith Law Group, 200 Oak St., Dallas, TX 75202, on October 15, 2026, at 10:00 a.m.

The items to be produced are described by category in Exhibit A, attached, with reasonable particularity.

Date: September 10, 2026

/s/ Maria Smith

One more Texas quirk worth knowing. If you ask a clinic for the health files of someone who is not a party, you must also serve that person with this notice. The party requesting it must also pay the nonparty’s reasonable production costs.

Attachment 3: the document list

This rider is the heart of the personal injury subpoena template. Attachment 3 in California does the same job as Exhibit A in federal court. Start with a short definitions and instructions section. Then list the records.

ATTACHMENT 3

DOCUMENTS TO BE PRODUCED

DEFINITIONS

“Patient” means Jane Doe, DOB 01/01/1990, SSN xxx-xx-1234.

“Records” means all charts, notes, images, films, and bills in paper or electronic form.

INSTRUCTIONS

Produce all responsive records in your care, custody, or control. If you withhold any item, state the reason.

RECORDS REQUESTED

  1. All records of care given to the Patient for the lumbar spine, neck, and left knee from June 1, 2024 through the present.
  2. All itemized bills and statements for that same care and date range.

Notice two things. First, the date range limitation. Second, the list names only the body parts at issue. That keeps the request tight and hard to attack.

Custodian of records declaration

A business records affidavit proves the files are real. In California, the custodian of records declaration accompanies the papers.

DECLARATION OF CUSTODIAN OF RECORDS

(Evidence Code sections 1561 and 1562)

I am the duly authorized custodian of records for Valley General Hospital. The copies attached are true copies of all records described in the subpoena. They were made in the regular course of business at or near the time of the act.

I declare under penalty of perjury that the foregoing is true and correct.

Date: ____________________ Signature: ____________________

Notice to Consumer or Employee (SUBP-025)

Judicial Council Form SUBP-025 is the notice to consumer or employee. California law requires that the person whose files are sought receive a warning first. The notice must tell them that records about them are being sought. It must tell them how to object. It must also tell them to call a lawyer about their privacy rights.

Skip this step, and it can cost you. Failing to serve SUBP-025 can trigger $500 in damages plus fees.

Proof of service

Your proof of service shows who served the papers, when, and how. Keep it. You will need it if the other side ignores you.

PROOF OF SERVICE

I served the foregoing subpoena on the Custodian of Records, Valley General Hospital, by personal delivery on September 12, 2026, at 11:15 a.m. I am over 18 and not a party to this action. Registered Process Server, PSR #5678, County of Los Angeles.

I declare under penalty of perjury that this is true.

Date: ____________________ Signature: ____________________

When You Need a Subpoena Duces Tecum in a Personal Injury Case

2-When-You-Need-a-Subpoena-Duces-Tecum-in-a-Personal-Injury-Case

What is a subpoena duces tecum?

What is a subpoena duces tecum? It is a written command to bring records. The term “subpoena duces tecum” comes from Latin. Duces tecum means “bring with you.” So the name tells you the job. Bring the papers.

Subpoena ad testificandum vs. subpoena duces tecum

There are two main kinds in an injury claim. A subpoena ad testificandum requires a person to appear and testify under oath. A subpoena duces tecum requires a person to turn over documents or other evidence.

You can also use a single sheet of paper for both jobs. That is a combined subpoena for testimony and documents. If you only want files, use a records-only subpoena.

Other names you will see:

Why party discovery is not enough

You can ask the other side for their files using a standard request. But a hospital is not a party. Neither is a phone company. To reach them, you need a subpoena to produce documents. A subpoena issued during discovery is the standard tool.

Subpoena vs. court order

This one matters a lot. A subpoena and a court order are not the same thing. If a judge signs it, a clinic may release files right away. If a clerk or a lawyer signs it, the clinic must take extra steps first.

Custodians who miss this point release files they should have held back.

What to Request: Records That Win Injury Cases

Here is what a sample subpoena for medical records and its cousins normally chase.

Record type Who holds it Common pitfall
Medical records Hospital, clinic Asking for the whole chart, not the hurt body part
Itemized billing records Billing office Forgetting to ask for the coded bill
Radiology films and imaging studies Imaging center Getting the report but not the film
Physical therapy records PT clinic Missing the visit notes
Emergency room records Hospital ER Missing triage notes
Ambulance and EMS run reports Fire or private EMS Wrong agency named
Prior medical history records Old providers Reaching back too many years
Employment and personnel records Employer HR No employee notice served
Wage loss and payroll records Payroll vendor Wrong pay period
Police accident report Police department Report not yet final
911 call recordings and CAD logs Dispatch center Tapes erased on a short cycle
Surveillance footage Store, city, business Video overwritten in days
Cell phone records Carrier Needs a court order in some states
Vehicle repair estimates and scene photos Body shop, adjuster Photos held by the insurer
Insurance claim file Carrier Fight over work product
Workers’ compensation file Comp carrier or board Separate rules apply
Social Security disability records SSA Federal release form needed

These requests can also cover accident scene photos, repair estimates, and even cell phone records used to prove a driver was distracted.

Write scope language that holds up

This is where most drafts fail. Plaintiff lawyers warn that defense subpoenas often reach back more than ten years and cover every body part, not just the ones in the claim. That kind of wording invades privacy and invites a fight.

So do the opposite. Name the dates. Name the body parts. Ask for what you can defend.

How to Fill Out the Sample, Step by Step

3-How-to-Fill-Out-the-Sample-Step-by-Step

Step 1. Fill in the caption. Copy the court name, party names, and case number from your filed complaint.

Step 2. Find the real custodian. Call the records desk first. Big chains often move records to one national office. Then write the custodian of records designation on the form.

Step 3. Draft the document list. Put it in the attachment, not the form face. Keep it plain.

Step 4. Set the production date. In California, you must command a date no sooner than 20 days after issuance or 15 days after service, whichever is later. Add a few extra days as a cushion. That date is your subpoena return date.

Step 5. Pick who signs it. California allows a clerk-issued subpoena, a judge-signed one, or an attorney-issued subpoena by counsel of record. New York is stricter. There, the judge’s signature requirement means the clerk takes your form to a judge for signature.

Step 6. Add the money. You owe witness fees and mileage. In California, you tender fees either with service or at the deposition itself.

Step 7. Serve it and paper the file. Then keep the signed proof.

Service Rules and Deadlines

How to serve a subpoena duces tecum

Personal service is the rule. A federal self-help guide explains that you cannot serve it yourself. Your server must be at least 18 and not a party to the case.

Most firms hire a registered process server. In California, that server has a PSR number, which strengthens the proof of service.

Tell the other parties first

Before you serve a records subpoena, you must send a notice and copy to each party. One expert group notes that missing this notice is a common reason a subpoena gets thrown out, and it happens most often under deadline pressure.

Consumer and employee notice timing

California adds a second clock. The consumer or employee must be served at least 10 days before you serve the witness. That drops to 5 days with hand delivery. And it must be at least 25 days before the production date.

The 100-mile rule

Federal law limits where you can compel compliance. Even though files travel by email now, the place of compliance must sit within 100 miles of the person you are asking.

Also know the difference between the issuing court and the court of compliance. Motions usually go to the court where the case is pending.

Deadline table

Setting Objection window Source
Federal civil Earlier of the compliance date or 14 days after service FRCP 45(d)(2)(B)
California civil Typically at least 3 days before the production date State practice guides
California records response 15 days after service, or 20 days after issuance, whichever is later CCP 2020.410

The federal 14-day objection deadline trips up many non-parties.

HIPAA Steps That Keep Medical Subpoenas From Being Refused

4-Responding-Objecting-and-Quashing

Health files are special. HIPAA, the Health Insurance Portability and Accountability Act of 1996, guards them. A HIPAA-compliant subpoena clears the hurdles below. One that does not gets bounced.

Satisfactory assurances

If a judge did not sign your paper, the clinic needs proof of one of two things. Either you tried hard to notify the patient, or you tried hard to obtain a qualified protective order. This is the satisfactory assurances letter required by 45 C.F.R. section 164.512(e).

What actually counts as proof

A cover letter is not enough. One compliance guide notes that a lawyer’s note stating the patient “has been notified” rarely qualifies. You need the notice itself, the proof of service, and proof that the objection window closed.

That gives the patient notice and a real chance to object.

Qualified protective order language

A protective order motion can solve this fast. The order must limit use of the protected health information (PHI) to this case only. It must also require that the files be returned or destroyed at the end.

Add a confidentiality designation to the records once they arrive. A judge may also use the court’s own sample form.

The cleanest path of all is a signed HIPAA authorization for release of records from your own client. No fight needed.

Ask for less, not more

The minimum necessary standard applies. One guide gives a sharp example. If the case is about a knee hurt in a crash, billing files for an unrelated mental health visit should not be handed over.

Files with extra armor

Some records get stronger shields. Psychotherapy notes, HIV status, and substance use disorder records under 42 C.F.R. Part 2 may need more than a subpoena. Courts also protect the plaintiff’s right to privacy in medical records.

Clinics and their vendors serve as covered entities and business associates.

Responding, Objecting, and Quashing

Got served? You have options. Ignoring it is not one of them.

Serve a written objection

A written objection is the cheap move. Once you serve it, you do not have to produce anything until the other side gets a court order.

File a motion to quash

A motion to quash asks the court to kill the subpoena. A motion to modify or limit asks the court to trim it instead. Under federal law, a court must quash when the paper gives too little time, reaches past the 100-mile line, seeks privileged matter, or is overly broad and unduly burdensome.

Good grounds include:

Courts weigh cost, time, page count, and the money at stake.

Drafting Mistakes That Get Subpoenas Quashed

  1. Skipping the consumer notice
  2. Using an old form revision
  3. Copying boilerplate scope with no dates and no body parts
  4. Setting a production date the statute does not allow
  5. Forgetting the fee tender
  6. Mailing to the wrong custodian address
  7. Losing the proof of service
  8. Aiming at a top executive when a records clerk has the files, which runs into the apex doctrine

Frequently Asked Questions

Who can issue a subpoena duces tecum? In many states, a lawyer of record can sign and issue one. A clerk or a judge can too. In some places, a self-represented person may issue one.

How long do I have to respond? In federal court, objections are due by the earlier of the compliance date or 14 days after service. California civil records are generally due within 15 days of receipt or by the date the parties agree.

Does a judge have to sign it? Not everywhere. New York says yes. California lets an attorney of record issue it.

Can I get medical files without the patient’s signature? Yes, but only with the HIPAA steps above. Otherwise, the clinic should refuse.

What is the difference between SUBP-010 and SUBP-020? SUBP-010 gets records only. SUBP-020 gets a live witness plus records.

Can a business charge me for copies? Yes. California allows clerical time and copying costs.

What if the custodian just ignores it? File a motion to compel. Then ask for sanctions or contempt.

Can I reach records from before the crash? Sometimes. But keep the years tight, or expect a fight.