Filling out a Copy Request Form
In order to obtain a copy of your medical record, you can do so by filling out the form either yourself or by authorizing someone else to obtain a copy of the record.
We kindly request the patient or their authorized representative to complete the form in its entirety and clearly so that we can provide you with the best service.
Please click on the link below to download the request form:
Submitting the Request
You can send the request via email to the Medical Records Department at NNUH at email@example.com, indicating "Request for a Copy of the Patient File" in the subject line. Please attach the following forms:
Completed Medical Record Copy Request Form.
Copy of the patient's ID.
Copy of the ID of the person authorized by the patient.
Preparing a copy of the requested medical record takes approximately (3 - 5) business days. The responsible medical records staff member will contact you by phone at the number provided in the request to inform you about collecting the copy of the file.
Receiving the Requested Medical Record Copy:
The copy of the medical record will be handed over in person, either in the presence of the patient or the authorized representative, in accordance with the completed request form. The patient or their authorized representative will sign a receipt form for the medical record copy, and it is essential to bring the required official documents as mentioned in the second step.