Application process

Please fill out the Application for Documents, and submit to the Document Service Desk (1st floor, Counter #9.)

For hospitalized patients : the following documents must be applied at your ward

• Documents urgently necessary for your company, etc. after discharge (Not a designated form)
• Medical Report or Letter to other hospitals

Notes upon Application

• You will need a physician' s consent beforehand depending on the document
• We ask the patient to be applied for documents at the counter. The documents will be sent through postal mail

  If it is difficult to visit the hospital, application through e-mail or postal mail will be also accepted. Please send us the application for Documents with a copy of your ID.

• In cases the claimant is not the patient, the documents below are additionally required:
  • An ID of the person applying (insurance card/driving license/my number card, etc.)
  • An authorization from the patient (within 3 months）

    When the authorization cannot be given by the patient, an extra documentation will be required. Please ask us for more information.

• Disclosure of Medical Information

Only patients have a right to ask for the disclosure of their medical charts. However, others may ask for the disclosure of our patient’s medical charts under these circumstances as below:

1. The attorney, if the patient has him/her
2. An arbitrarily-chosen conservator who has the authority of representation for medical treatment codes
3. Relatives or those who received the authorization from the patient
4. Relatives or those taking care of the patient, when it is suspicious that patient have an appropriate capacity for judgment even though he/she is above 20

Documentation Counter/Business Hours

Type of Document

Items	Fee (JPY)
Medical Certificate for insurance (Japanese)	7,027
Medical Certificate in free format(Japanese)	3,718
Medical Certificate in free format(English)	5,958
Medical Certificate in Hospital Format (English)	3,718
Death Certificate(Japanese)	3,718
Death Certificate(English)	5,958
Birth Certificate(English)	5,958
Examination Results(Per examination)	61
X-ray Film(CD-R)	1,324
Medical Record Disclosure Fee	5,500
Copy of Medical Record(per page)	27
Discharge of Summary	3,300

Document Translations

Documents, such as itemized bill for the insurance claim or test reports will be issued only in Japanese.　However, most major insurance companies have their own translation departments and accept documents in Japanese. Please inquire with your insurance company if they can accept documents in Japanese. If the insurance company still demands documents in English, please contact a professional translation company/agency at your own volition. One such company we can introduce is as follows:

Please contact the above company directly in regards to timelines and fees.