By e-Form
Please click here to apply:
Request for a Medical Report
By Mail
Please download and complete the below form:
Form A Consent Form - 18122024
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
Payment Mode:
Credit Card
PayNow (Payment notification will be sent to you)
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.pdf 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
Referral Letter from polyclinic or private medical centre provided by the patient
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. Alternatively, if you prefer to receive the completed report via Health Buddy, you will need to request in the application form.
Hardcopies will only be provided upon request via registered mail with charges.
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 a standard practice across all restructured hospitals in Singapore.
There will be no refund on payment once the application had been processed.
You may contact us at:
Health Information Management Services Medical Registry & ReportsTel: (65) 6322 9499 Email: [email protected] Monday to Friday: 8.30am - 5:30pm
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