In cases where patients request the disclosure of their medical information, our hospital shall disclose the information in accordance with the regulations governing the disclosure of medical information established by Kanto Central Hospital of the Mutual Aid Association of Public School Teachers.
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Who can make a disclosure request
In principle, requests for the disclosure of personal information must be made by the patient in question, since this is considered personal information that is important to the patient.
However, if the patient whose personal information is to be disclosed is deceased, the request must be made by a family member within the second degree of kinship. In the case of a patient who is a minor or an adult ward, a statutory representative may request disclosure on behalf of the patient. If the patient is 15 years of age or older, the patient’s consent is also required.
*For disclosure requests made by someone other than the patient in question, please enquire in advance about the necessary documents that must be brought along.
*In principle, we do not accept by-proxy requests made through law firms (except for adult guardians of patients). The patient is required to visit the hospital in person to make a disclosure request. After the request is made, the patient may designate a proxy to receive the disclosed medical information through a power of attorney.
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Medical information that can be disclosed
①Medical records (doctor’s medical records, nursing records, etc.)
②Prescriptions and examination records (blood tests, pathological investigations, etc.)
③Imaging data (X-ray films, etc.)
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How to make a disclosure request (Requests made by post are not accepted.)
Operating hours: Weekdays (Mondays to Fridays), 9:00 AM to 5:00 PM
Please prepare the following documents and submit them to our hospital’s person-in-charge. The information will typically be disclosed within 14 days.
However, this period may be extended to a maximum of 30 days if the disclosure cannot be made within 14 days due to unforeseen circumstances. In such cases, the requesting party will be informed of the reason for the extension in writing.
①“Medical Information Disclosure Request Form” (in our hospital’s format)
②Requesting party’s ID (e.g., driver’s license, passport, My Number card, or other forms of photo ID. If you do not have a photo ID, please prepare a combination of multiple forms of ID, such as your health insurance card and pension booklet, etc.)
③In cases where the request is made by a family member of a deceased patient, in addition to (1) and (2) above, the requesting party is also required to bring along proof of their relationship to the patient (e.g., a certified copy of the family register, the invalidated family register, etc.) and proof of the patient’s death (e.g., a certified copy of the closed family register, etc.).
④In cases where the request is made by a patient’s statutory representative, in addition to (1) and (2) above, the requesting party is also required to bring along a “Power of Attorney” (in our hospital’s format) and proof of their relationship to the patient (e.g., a certified copy of the family register, a certified copy of the closed family register, or other documents that prove that the requesting party is the adult guardian of the patient).
⑤*Please note that our hospital will retain a copy of the ID document presented after it is verified.
⑥Seal (Shachihata stamps are not accepted)
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Rejection of medical information disclosure request
Our hospital may reject a medical information disclosure request, either wholly or in part, in cases where the medical information requested by the requesting party falls under any of the following.
①When disclosure of the medical information may cause significant harm to the patient’s physical or mental condition
②When disclosure of the medical information may harm the interests of a third party
③When disclosure of the medical information is deemed to be contrary to the interests of the minor, in cases where the disclosure request was made by a statutory representative of a minor
④When there are other reasonable grounds to deem the disclosure of the medical information inappropriate
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Cost of disclosure of medical information (prices stated include consumption tax)
①Disclosure fee: 5,500 yen
②Viewing fee (for up to 1 hour): 3,300 yen
③Reproduction fee (copying fee)
- Electronic medical records: 22 yen per sheet (A4, b/w)
- Paper-based medical records: 33 yen per sheet (A4, b/w)
- Color: 55 yen per sheet
- CD-ROM of imaging data (X-ray, CT, MRI): 3,300 yen per copy
Please note that the disclosure fee must be paid at the time of making the disclosure request, and all other fees must be paid during the disclosure and handing over of the information.
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“Certificate of the Absence of Medical Records” for lawsuits involving hepatitis B and C (in cases where these records are not stored at our hospital)
Please contact us at the following.
It takes around one week for the certificate to be issued.
