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Administration & Rights

Requesting Medical Records

Copies of medical records can be requested for personal use, follow-up consultations, or sharing information with other healthcare professionals. This page explains who may make a request, which documents to prepare, and how to submit it.

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Guide contents

Who Can Request Medical Records

  • The patient

    For personal use, follow-up consultations, or other medical purposes

  • The patient's legal representative

    A family member, guardian, or representative of the patient, with a power of attorney letter and documents proving the legal relationship

  • Healthcare institutions or insurers

    Hospitals, clinics, or insurance companies, with the patient's written consent

Documents for Patients

Complete the following documents so your request is not delayed.

  • Photocopy of your national identity card (KTP), family card (KK), or Heartology Patient Card

    Currently valid

  • Medical records request form

    Available at the counter, or can be downloaded from this page

  • Treatment period

    For example, "January 2023" or "after heart surgery in 2022"

  • Type of documents requested

    Laboratory and test results, surgery reports, prescriptions, or inpatient records. You may request more than one

Documents for Representatives (Family or Guardian)

  • Power of attorney letter from the patient, with a revenue stamp (meterai)

    Signed by the patient and stating the purpose of the request

  • Photocopies of the national identity cards (KTP) of the patient and the applicant

  • Documents proving the legal relationship

    A marriage certificate or birth certificate for family members; a guardianship letter or court ruling for guardians

Documents for Institutions (Hospitals, Clinics, or Insurers)

  • Official request letter on the institution's letterhead

    Or an official request form from the institution

  • Patient consent letter

    Stating the patient's full name, medical record number, the type of medical records and date range of the documents requested, and the purpose of use

  • Validity period of the consent

    Stated in the consent letter, for example 30 days from the date of signing

  • Patient's signature and the institution's stamp

    On the consent letter

Requesting in Person at the Counter

The counter is on the 1st Floor and is open Monday to Saturday from 08.00 to 21.00 WIB. This option suits you if you need the records quickly or need physical documents.

  1. Take a Queue Number

    Take a queue number at the counter.

  2. Submit Complete Documents

    A photocopy of the applicant's national identity card (KTP), the request form (available at the counter), and a power of attorney letter with a revenue stamp if you are representing the patient. There is no administrative fee for the first request [KONFIRMASI: biaya untuk permintaan berikutnya].

  3. Receive a Receipt

    Our staff will give you a receipt along with the estimated completion time.

Requesting Without Visiting in Person

For patients who live outside the city or cannot come to the hospital. Copies are sent by an official courier service or by encrypted email.

  1. Get the Form

    Download the form from this page, or request the form by email from the medical records unit.

  2. Fill Out the Form and Prepare the Attachments

    Attach a photocopy of your national identity card (KTP) or Patient Card, and a power of attorney letter with a revenue stamp if needed. Scan the documents clearly (at least 300 dpi) in PDF or JPG format, up to 5 MB per file.

  3. Send Your Request

    Send it to the Medical Records Department of Heartology Cardiovascular Hospital.

  4. Receive the Copies

    Requests are processed within 5 to 7 working days after the documents are received.

After Your Request Is Received

To protect patient privacy, every request is verified first.

  1. Document Validation

    Documents such as the national identity card (KTP) and power of attorney letter are validated within 24 hours after the request is received.

  2. Confirmation with the Patient

    If needed, we will contact the patient by phone or email for confirmation.

  3. Notice of Missing Documents

    We will let you know if any documents are missing or invalid.

Processing Time and Fees

Estimated completion time:

  • Standard: 3 to 5 working days, for online or in-person requests with complete documents.
  • Priority: 1 to 2 working days. Write "URGENT" on the form. An additional fee of Rp75,000 applies.
  • By post: 5 to 7 working days, including delivery time for physical documents.

There is no administrative fee for the first request.

Processing may take longer if:

  • Documents are incomplete. We will notify you by phone or email.
  • The requested medical records are more than 5 years old, because it takes time to search the archives.

Sample Power of Attorney Letter

The power of attorney letter is signed by the patient over a Rp10,000 revenue stamp (meterai). Sample content:

"I, the undersigned, [Patient Name], holder of KTP No. [XXX], hereby authorize [Representative Name] (KTP No. [YYY]) to collect my medical records at Heartology relating to [Type of Treatment] for the period [Date]. This letter is valid until [Expiry Date]."

Download Forms

Location and Contact

Address
Jl. Birah III No. 4, Kebayoran Baru, Jakarta Selatan, DKI Jakarta, 12180

Next steps

Questions About Requesting Medical Records?

You can send your documents via WhatsApp to have them checked for completeness before you submit your request.

Ask on WhatsApp (opens in a new tab)

Guides You May Need

Patient PrivacyPatient Rights and ResponsibilitiesFrequently Asked Questions
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