Request for Medical Information

Other Services

1. Submission of Request for Medical or Dental Information

If you wish to request for your medical or dental information, please submit your request via our online form.

Please prepare the following documents:

Supporting documents. Please see “Supporting Documents" section below for more details.

Payment for the information required. Please see "Services & Payment" section below for more details.

All details must be verified before submission and all necessary supporting documents must be included. Requests will only be processed upon receipt of completed form, required supporting documents, and full payment of fees through the FormSG platform.

Notes:

Patients below 21 years of age: Parental consent is required for patients below 21 years of age.

Patients who are unable to give consent: The requestor should be the donee appointed by the Patient under a Lasting Power of Attorney or court-appointed deputy for the Patient.

Patients who are deceased: The requestor should be the appointed executor or administrator of the Patient's estate

a) If there is no donee or executor/administrator of the Patient's estate appointed, the applicant who is applying for the release of the Patient's medical information must be an immediate Next-of-Kin (NOK) of the Patient based on the order of priority set out below. If there is an immediate NOK with higher priority, then that NOK must be the applicant (e.g. spouse must be the applicant if Patient has a spouse, children, parents and siblings):

                 i. First priority: Spouse
                  ii. Second priority: Children
                 iii. Third priority: Parents
                 iv. Fourth priority: Siblings

b) The immediate NOK, who is the applicant, must complete and execute both Sections 1 and 2 of this consent form.
c) All other immediate NOKs (i.e. spouse, children, parents and siblings) who are alive, must consent to the application by completing and executing Section 1 of this consent form, regardless of the identity of the applicant.

2. Supporting Documents

Requestor’s Relationship to Patient	Patient is below 21 years old (Requestor should be parent/guardian)	Government agency makes application (including CPF/SPF)	Other third party makes application on behalf of patient who is not deceased and does not lack mental capacity
Patient’s NRIC			✓
Requestor's NRIC (where requestor is an individual who is not the patient)	✓		✓
Patient’s Birth Certificate	✓
Letter of Request w written agreement to payment terms *Statutory act or procedure code to be indicated		✓
Letter of Authorisation executed by patient			✓

Requestor’s Relationship to Patient	Self	Patients who are unable to give consent
Requestor’s Relationship to Patient	Self	LPA exists (Requestor should be donee)	No LPA but there is court-appointed deputy (Requestor should be deputy)	No LPA or court-appointed deputy (Requestor should be spouse/child/ parent/sibling/ other relative)
Patient’s NRIC	✓ (if SingPass is not used)	✓	✓	✓
Requestor's NRIC (where requestor is an individual who is not the patient)		✓	✓	✓
Lasting Power of Attorney (LPA)		✓
Medical Report/Memo certifying patient's lack of capacity (Note: For LPA cases, MSF has a sample medical report for activation of LPA		✓	✓	✓
Court order appointing deputy			✓
Supporting documents proving Requestor’s relationship with Patient (e.g. marriage cert, birth cert)				✓
“Consent for Release of Medical Information by All NOK" form				✓

Requestor’s Relationship to Patient	Patients who are unable to give consent
Requestor’s Relationship to Patient	Executor is appointed	Administrator is appointed	No executor or administrator is appointed (Requestor should be spouse/child/ parent/sibling/ other relative)
Patient’s NRIC	✓	✓	✓
Requestor's NRIC (where requestor is an individual who is not the patient)	✓	✓	✓
Supporting documents proving Requestor’s relationship with patient (e.g. marriage cert, birth cert)			✓
“Consent for Release of Medical Information by All NOK" form			✓
Death Cert	✓	✓	✓
Supporting documents proving Requestor is executor (e.g. grant of probate)	✓
Supporting documents proving Requestor is administrator (e.g. letter of administration)		✓

3. Services & Payment

Services Available	Price (including 9% GST unless expressly stated otherwise)
Medical/Dental Report This is a factual report of the patient's condition. A doctor will write the report based on patient's information available (Type-written report).	$114.50 (SG citizen/PR) $124.81 (Non-resident)
Duplicates/Memo with Endorsement This is either a reprint of documents with signatory or a simple memo with signatory.	$5.80 (SG citizen/PR) $6.32 (Non-resident)
Mailing of results (with courier)	$7.00 (SG citizen/PR) $7.63 (Non-resident)

Notes:

The appropriate payment amount is to be submitted through the new FormSG platform. Submissions using other payment methods will be rejected and refunded.

4. How long does it take?

As a general guide, the time frame for completion of medical reports (from approval date) is about 3 weeks.

It may take longer due to the following:

Patient has upcoming clinic appointments

Patient has been hospitalised

Multiple reports are required from several clinical departments

Doctor is away

5. How do I receive it?

Patients will be able to request for the medical report to be:

Mailed to them via Courier (additional S$7.00 for SG citizen/PR or $7.63 for Non-resident is applicable) – Mailing address to be provided on the application form.

Emailed to them - Email address to be provided on the FormSG and the password to the report will be provided via SMS to the number provided on the FormSG.

Collected personally at the respective Polyclinics – the patient's contact number is to be provided on the application form. Patient will be contacted once the report is ready for collection.

If a third party is collecting the report for you, please fill up the Proxy Authorisation Letter.