Dear patients, dear patients,
If you need to consult your medical records (hereafter referred to as "MDR"), take an extract or copy, or file an insurance claim, please pay attention to the text below.
How to proceed?
You can request to inspect the medical records, obtain an extract or copy or file an insurance claim using the form available from the Quality of Care Department, the hospital headquarters, the hospital reception or the hospital website.
Request for copy of statement and access to medical records.pdf
How can you make a request?
- By email: zadostizd@nember.cz
- In person: at the Quality Department, by appointment - tel. 311 745 275
Who can apply and what is required for the application?
- Patient - ID card and a second form of identification (e.g. driver's license, passport).
- Legal guardian of a minor - ID card of the legal guardian and birth certificate of the minor.
- Guardian - guardian's ID card and court decision
- Person appointed by power of attorney with a well-defined scope* - power of attorney and ID card of the attorney
- For a deceased person close to the deceased** - death certificate, birth certificate and ID card of the person close to the deceased
What will follow?
1. A copy or extract of the POA
- The Quality Officer will arrange for a copy or extract of the RO within 30 days of receipt of your request. The copy or extract can be collected in person, sent by registered post, by email in the form of a sealed file or by data box.
2. Inspection of the SO
- A member of staff from our hospital will arrange a time with you to look at your records. You can only look at the records under the supervision of our staff. You can make copies by your own means.
3. Completion of the insurance claim
- A member of the Quality Department will arrange to complete the insurance claim within 30 days of receipt of your request. The completed form may be collected in person or sent by registered post.
Payment for consulting medical records, obtaining an abstract and copy, and filing an insurance claim is governed by the Administrative Fee Schedule.
Shipping costs: according to the current price list of the Czech Post, s.p. for registered mail.
* power of attorney expires upon the death of the patient, unless otherwise stated in the text
**parents, grandparents, children, grandchildren, sibling, spouse and registered partner
