Requests for Medical Certificates

To request a medical certificate, please go to the Medical Records/Certificates.

Documents issued: Medical certificates for insurance companies, health insurance invalidity benefit certification, etc.
Note: Documents such as certification of receipt of payment and medical certificates for automobile liability insurance are issued at the Cashier (Receipts).

Please take the following items to the Medical Records/Certificates.
◇ Hospital Card
◇ Application form for Medical Records/Certificates (available at the desk)
◇ Format for medical certificate or other type of certification required by the requesting insurance company or other organization
◇ Return envelope (documents will be sent to your home address within three weeks)
Write the name and address of the addressee on the envelope, and affix postage stamps.
Amount of stamps: As a guide, the postage cost for 1-4 pages of A4 is ¥82 (regular mail) or ¥382 (registered mail).
◇ If you are not the patient, a letter of authorization and a personal identification document (such as a drivers license)
◇Document cost (please pay at the time of application)
Note: Documents will be issued after payment has been received.

◆ Documents will be sent to the patient's home address as soon as they are ready. Please allow three weeks for this.
◆ Applications cannot be cancelled (after documents have been prepared).
◆ If certificates from multiple clinical departments are required, in principle these will be prepared separately for each department.(If a patient changes departments in the course of a single period of hospitalization for the same medical problem, documents will be prepared by the last clinical department concerned).

◆ Please apply at the Medical Records/Certificates.

Patients who live a long distance away and wish to apply by post are requested to consult the Medical Records/Certificates, separately.

Medical Records/Certificates.
Outpatient Building 1F
Tel: 052-744-2580
Open weekdays 8:30-17:15