Requesting Medical Records

Requesting Medical Records at Samitivej Chonburi Hospital

• To request medical records of a patient, please follow the procedures through one of the following channels:
  o  Email: Send your request to [email protected] (Recommended)
  o In-person: Visit Third Party Payer Service Department, 1st Floor, Building A
  o Telephone: Call +66 3303 8888, extension 10193 – 10192, available daily from 8:00 AM to 8:00 PM
  o  Postal Mail: Address to Samitivej Chonburi Hospital  888/88 Moo 3, Sukhumvit Road, Ban Suan Subdistrict, Mueang District, Chonburi 20000 (Third Party Payer Service Department)

Documents Required for Requesting Medical Records

• If the owner of the records requests and receives the records personally:
  • A signed copy of the national ID card
  • For patients under 20 years old, provide the birth certificate and a copy of the parent's ID card
• If another person requests and receives the records on behalf of the patient, additional documents are required:
  • A signed copy of the representative’s national ID card
  • A consent letter: If you wish to disclose information to another person or if someone other than the patient is requesting the records, please attach a consent letter specifying the authorized representative's name.
• If the patient is not the one making the request, the hospital will contact the patient to confirm consent. Therefore, the processing of the documents can only proceed after receiving the patient's or guardian's consent.
• Processing Time: The document preparation process takes approximately 3 to 5 days (excluding the time for patient confirmation and EMS delivery). If urgent, please specify the required date clearly. Processing time may exceed the specified duration if the patient has specialized medical records requiring the attending physician’s review.

Payment Methods for Requesting Medical Records for Insurance (300 THB)

Bank Transfer: Account Name: Samitivej Chonburi Co., Ltd.

• Bank of Ayudhya, Account No. 245-150-5129
• Kasikorn Bank, Account No. 293-260-0989

At the Hospital's Financial Counter

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Medical Records Service, Samitivej Chonburi Hospital

• Open daily, operating hours from 8:00 AM to 8:00 PM
• Phone: 033-038888, extension 10193–10192
• Email: [email protected]