Application for a copy of own medical records

Attention: Is your copy meant for use by another doctor or a second opinion, please authorize that doctor to claim your medical records. This is usually a faster procedure.

Patient details

The patient requests the following records:

(tick the box,  subject, period and location are mandatory)

Costs: 10 euro per request

N.B. Generally you receive your specialist’s letter which was sent to your general practitioner, in which an overview is included of the specialists findings during your treatment.

Your request will be dealt with within four weeks. If you do have any questions, please contact the departments medical secretary of the department in question.

Be aware: To avoid delay in releasing your medical records, please ensure you fill out this form completely. Do not forget to provide a copy of your means of identification* when inspecting or collecting your medical records from the hospital.

*Valid means of identification:

  • Passport
  • Identification card
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