• MEDICAL REPORT APPLICATION 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:-

    MEDICAL RECORDS

    Request for Medical Records  


    Health Information Management (Medical Record) Services main objectives are to provide comprehensive, accurate and up to date information for purpose of treatment services to patients. The services functions to manage centralized medical record system ensuring confidentiality, safe, custody, quick retrieval and proper control of movement of all medical records in the hospital.

    Medical reports are documents requested by patients for insurance claims, courts, employers and others provided by the specialist or medical officer. Medical report can be obtained from HIM Services, Level 4 or send applications via email to tawakkal.mr@kpjtawakkal.com. Patients are required to fill up the Consent for Release of Medical Information (Medical Report) form. 


    A. PATIENT (SELF)
    § Copy of IC/Passport
    § Deposit of RM80.00
    § Related form (Insurance /EPF/SOCSO)
    § Original Consent for Release of Medical Information form

    B. PATIENT (patient below 18 years old)
    § Copy of Birth Certificate
    § Copy of parents/guardian’s IC
    § Deposit of RM80.00
    § Related form (Insurance /EPF/SOCSO)
    § Original Consent for Release of Medical Information form


    C. AGENT /REPRESENTATIVE
    § Original consent letter from patient /relative (mention name agent /representative/applicant )
    § Copy of patient /relative‘s IC /Passport
    § Copy of agent’s IC
    § Related Form (Insurance /EPF/SOCSO)
    § Copy of Burial Permit/Death Certificate (if patient passed away)

    Medical Report Counter Operation Hour:


    Monday – Friday : 8.30am – 5.00pm


    Saturday : 8.30am – 12.30pm


    Sunday & Public Holidays: Closed


    Further enquiries on medical reports, please contact 03-4026 7777 Ext: 4007