Requirements for procedures for delivery of Medical Records

• Where can you request your medical history?

  You can go to the Intermédica Tower (Calle 7 # 39-197) 1st floor, office 106 IQ InterQuirófanos.

• Schedule for requesting medical records?

  Opening hours: Monday to Friday from 7:30 a.m. to 12:00 p.m. and from 2:00 p.m. to 4:30 p.m.

• If it is your Medical History, you must present:

  Original identification document. Photocopies are not accepted.

• If you are going to claim someone's Medical Records, you must have the patient's authorization. You must present:

  -Authorization letter with the patient's personal data (Letter addressed to IQ InterQuirófanos, full name, identification document number, telephone number and/or email of the patient, full name of the person to whom the authorization is given, identification document, relationship; it must be signed by the patient and by the person authorized to request the history). -Copy of the patient's identification document on both sides. -Original identification document of the authorized person.

• If you are the parent, mother or legal representative of a minor patient, you must present:

  -Original identification document of the applicant: father, mother or representative. -Copy of the documentation that accredits him/her as father, mother or legal representative and/or relationship (birth certificate or document that accredits him/her as legal representative). -Copy of the minor's identification document.

• If you are a family member of a deceased patient, you must present:

  -Copy of the identification document of the person requesting it. -Copy of the civil registry (birth, marriage or extrajudicial declaration of cohabitation as the case may be) in order to prove the relationship with the holder of the Medical Record. -Copy of the civil registry of death, to prove that the patient is deceased (Applicable for patients who have NOT died in the IQ InterQuirófanos). -Fill out the form established by the institution FTHC015 Request for Medical Record of a Deceased Patient or Patient with a Physical or Mental Disability. -This request is only made in person.

• If you are a family member of a patient who is incapacitated and of legal age (unconscious, mentally or physically incapacitated), you must present:

  -Original identification document of the person requesting the application. -Copy of the civil registry of birth, marriage or declaration of de facto marital union (as the case may be), in order to prove the relationship with the holder of the Medical Record. -Copy of the medical certificate that shows the physical or mental health status of the patient. -Fill out the form established by the institution FTHC015 Request for Medical Record of a Deceased Patient or Patient with a Physical or Mental Disability. -This application is only made in person.

• Request for Medical Records by Email.

  -Letter addressed to IQ InterQuirófanos (Full name, identification document number, telephone number and email of the patient) or download and complete the FTHC009 Medical History Request form and send it to the patient's email address) or download and complete gd@iqinterquirofanos.com. -Sign the same way you signed the identification document. -Attach a copy of the identification document on both sides. -Please note that this request can only be made directly by the patient.