First, download the Consent Form here download form
Once the documents are verified by the Medical Record Department, the medical record will proceed to send the patient’s medical report via
Once the documents are verified by the Medical Record Department, the medical record will proceed to send the patient’s medical report via
Requestor | Application Form | Consent Form | Patient’s Photocopy ID or birth Certificate | Death Certificate | Requestor’s Photocopy ID | Signed Authorization Letter |
---|---|---|---|---|---|---|
Patient | Yes | - | Yes | - | - | - |
3rd party on behalf of | Yes | Yes (Signed by patient) | Yes | - | Yes | Yes (if collected by other than patient or requestor) |