Please click here to apply:
Request for a Medical Report
Please download and complete the following forms:
Form A - Application & Consent for Release of Medical Information Form
Mail Order Form (For credit card payment)
For cheque payment, please enclose a crossed cheque made payable to "Singapore National Eye Centre Pte Ltd" and indicate patient’s name & last 4 characters of the NRIC at the back of the cheque.
Please attach a photocopy of patient’s NRIC (front and back view) and other supporting documents e.g. Insurance Claim Form, birth/marriage/death certificates etc.
Mail your application to:Health Information Management Services
Medical Registry & ReportsSingapore National Eye Centre
11 Third Hospital Avenue Singapore 168751
Patients aged 21 years and above who will provide written consent for the release of medical information.
If the patient is below 21 years old, the consent of the patient’s legally appointed representative (parent/guardian) is required.
If the patient is deceased or mentally incapacitated, the patient’s next-of-kin or legally appointed representative may apply with relevant supporting documents.
Interested third parties (e.g. insurance companies) may apply with patient’s written consent.
Please refer to
Notes on Application for the Release of Medical Information for more details.
Copy of patient’s birth certificate
Copy of parent’s/guardian’s NRIC/FIN (front and back)
Copy of death certificate
Proof of applicant’s relationship to the deceased (e.g. marriage/birth certificate/letters of administration).
Form B - Letter of Undertaking
Proof of applicant’s relationship to the patient (e.g. marriage/birth certificate/letters of administration)
The application form is incomplete and / or supporting documents required for verification are not produced
Patient has multiple reports requested from several clinical departments
Patient has upcoming / frequent clinic appointments
Patient has been admitted to the ward
Doctor is away
Referral Letter from polyclinic or private medical centre provided by the patient
The form is to be provided by the patient
S$157.25 or S$280.85
Report will be sent directly to MOM / Insurance Company
All completed medical reports will be encrypted in PDF and sent to the recipient’s email address. Hardcopies will only be provided upon request via registered mail. There will be postage fees incurred for registered mail.
The regular consultation and hospitalisation fees paid do not include cost for a medical report as not every patient requires one.
A fee has to be levied for this additional service of providing medical reports to cover the hospital’s administrative costs and the doctor’s professional input. This is standard practice across all restructured hospitals in Singapore.
You may contact us at:
Health Information Management Services
Medical Registry & ReportsTel: (65) 6322 9499
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