Patients/Next of Kin/Agents may request for medical report application at Health Information Management System (HIMS) Services via counter only. Consent for Release of Medical Information (Medical Report) must has a valid written signature from the patients before we release to any third party. The consent form may be obtained at HIMS Counter at Level 1, KPJ BMSH. The process for the report to be completed is within 2 to 4 weeks’ time and full fees will be collected upon completion of the report. You will be notified via phone once the report is ready to be collected.
A deposit of RM100 will be collected from Lawyer Firm for any Medical Report/Initial Report/Specialist Medical Report requested. Full fees will be collected upon completion of the report.
Please take note of the list of documents you need to prepare as below, in order to obtain the medical reports:-
PATIENT (SELF)
1. Copy of IC/Passport
2. Related forms (Insurance/EPF/SOCSO/Formal Request Letter)
3. Consent form - “CONSENT FOR RELEASE OF MEDICAL INFORMATION (MEDICAL REPORT)”
PATIENT (PATIENT BELOW 18 YEARS OLD)
1. Copy of MyKid/IC/Passport
2. Copy of parents/guardian IC/Passport
3. Related forms (Insurance /EPF/SOCSO/Formal Request Letter)
4. Consent form - “CONSENT FOR RELEASE OF MEDICAL INFORMATION (MEDICAL REPORT)”
AGENT / REPRESENTATIVE
1. CONSENT FOR RELEASE OF MEDICAL INFORMATION (MEDICAL REPORT) from patient/relative (with mention of agent/representative/applicant’s details)
2. Copy of patient’s/relative’s IC/MyKid/Passport
3. Copy of agent’s IC/Passport
4. Related forms (Insurance /EPF/SOCSO/Formal Request Letter)
5. Copy of burial permit/death certificate (if patient has passed away)
NEXT OF KIN (SPOUSE/PARENT/CHILD/SIBLING)
1. CONSENT FOR RELEASE OF MEDICAL INFORMATION (MEDICAL REPORT) from patient/relative (with mention of agent/representative/applicant’s details)
2. Copy of patient‘s IC/MyKid/Passport
3. Copy of applicant’s/relative’s IC/passport
4. Letter of statutory declaration/letter of court order (if applicable)
5. Copy of burial permit/death certificate (if patient has passed away)
6. Related forms (Insurance/EPF/SOCSO/Formal Request Letter)
LAWYER FIRM
1. Request Medical Report letter by Lawyer
2. Early Payment (Deposit RM100)
3. CONSENT FOR RELEASE OF MEDICAL INFORMATION (MEDICAL REPORT) from patient
4. Copy of patient‘s IC/MyKid/Passport
5. Copy of applicant’s/relative’s IC/passport
6. Letter of statutory declaration/letter of court order (if applicable)
7. Copy of burial permit/death certificate (if patient has passed away)
