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Issuance Service

Process for medical record release

  • Make an appointment with doctor : Each and every department from which you require the medical records
  • Doctor consultation : To obtain Doctor’s medical record copy order
  • Pay bill for medical record copying
  • Fill out the application for medical records copying : Submit applicant’s ID & required documents
  • Issuance of medical records copies

Required documents for perusal or medical record release

Patient Applicant Required documents
When the patient is 14 years of age or older Patient (him/herself) Photo ID (alien registration card, passport or driver’s license)
Next of Kin
(spouse, patient’s direct ancestor or descendant, or spouse’s direct ancestor)
  1. 1. Applicant’s Photo ID
  2. 2. Certified document of kinship
    (certificate of family relationship or birth certificate)
  3. 3. Consent signed by patient
  4. 4. Copy of patient’s Photo ID
Person delegated by patient
(ex. insurance company)
  1. 1. Applicant’s Photo ID
  2. 2. Consent signed by patient
  3. 3. Power of attorney signed by patient
  4. 4. Copy of patient’s Photo ID
When the patient is under the age of 14 Next of Kin
(spouse, patient’s direct ancestor or descendant, or spouse’s direct ancestor)
  1. 1. Applicant’s Photo ID
  2. 2. Certified document of kinship
    (certificate of family relationship or birth certificate)
Person delegated by patient
(ex. insurance company)
  1. 1. Applicant’s Photo ID
  2. 2. Consent signed by Legal Guardian
  3. 3. Power of attorney signed by Legal Guardian
  4. 4. Certified document proving qualification as a Legal Guardian
  5. 5. Copy of Legal Guardian’s photo ID
  • * Direct ancestor or descendant: parents, grandparents, offspring, grandchildren
  • * Siblings are considered as ‘Person delegated by patient’.
  • * Consent or Power of attorney should be the original document.

Required documents for perusal or medical record release
- Unable to get the consent from the patient

Case Required documents
When the patient has died
  1. 1. Applicant’s Photo ID
  2. 2. Certified document of kinship (certificate of family relationship or birth certificate)
  3. 3. Document proving the death of patient (certificate of family relationship or death certificate)
When the patient is unconscious or unable to sign (because of severe illness or injury)
  1. 1. Applicant’s Photo ID
  2. 2. Certified document of kinship (certificate of family relationship or birth certificate)
  3. 3. Medical certificate stating patient’s disability to sign because of severe disease or injury
When the patient is missing
  1. 1. Applicant’s Photo ID
  2. 2. Certified document of kinship (certificate for family relationship or birth certificate)
  3. 3. Copied resident registration, copied official document from the court, that can approve the fact of disappearance
When the patient is mentally incapable
  1. 1. Applicant’s Photo ID
  2. 2. Certified document of kinship (certificate for family relationship of birth certificate)
  3. 3. Copied document of patient’s incompetency sentence from the court or any medical certificate approved by psychiatrist
  • * Only next of kin (spouse, patient’s direct ancestor or descendant, or spouse’s direct ancestor) are applicable

Power of Attorney for Releasing Medical Records Consent for Perusal or release of medical record Instruction and Application for copy of medical records