Online application

Online application

Email address for online application: m963@mail.cmuh.org.tw

Documents required for collection: please study the “Content of Application for Copies of Medical Record Online Application”

Application eligibility

Application Eligibility: Patients, family or legal agent
The patient shall apply and complete the "Online Application for Medical Record Copies"in person.
The agent shall apply and complete the "Online Application for Medical Record Copies"and "Agent Letter of Authorization"
After completing the aforementioned data, please mail to m963@mail.cmuh.org.tw

Collection site

Please bring your ID to Lifu Medical Building 1F Admission Center to collect from "Duplicate Medical Record Application/Collection Site"

No. of working days

Copies of medical record and report: One working day and up to 3 working days in general.
Full replicate of medical record: Three working days and up to 14 working days for delivery in general.
Chinese medical record summary: 14 working days for delivery in general.

Charge

Copies of medical record and report: (basic fee (1 copy) NT200, additional NT5 per copy for more than one copy.
Chinese medical record summary:NT500/discipline, 7-14 working days for collection.
CD Rom:Single examination NT200; two examinations NT 250; three examinations NT 300; four examinations NT 350.
Color examination report and trauma photo printing:Basic fee NT 200 and additional NT40 per print.
X-ray film:NT200 per film.
CD Rom:Single examination NT200; two examinations NT 250; three examinations NT 300; four examinations NT 350;
Five examinations NT400; six examinations NT450; seven or more examinations NT500.
(For each additional CD Rom, additional NT100 will be charged per CD)
Self-paid postage: Postal (prompt registered) NT50, courier NT120.
※The Personal Information Protection Act requires the verification of original ID and hence postal delivery service may not apply to online application.

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