A) If you are the patient aged 18 years or older:

1. Application & Consent To Release Medical Information Form
2. Copy of NRIC (Identity Card) or Passport
3. Purpose-Specific Forms (if applicable)

- Insurance claim forms, KWSP / PERKESO / SOCSO forms, lawyer letters, etc., depending on the report use.

B) If the patient is under 18 years old or mentally incapacitated:

(A parent or legal guardian must apply on behalf of the patient)

1. Application & Consent To Release Medical Information Form
2. Copy of Patient’s Birth Certificate
3. Copy of Patient’s NRIC / Passport
4. Copy of Parent / Guardian’s NRIC or Passport
5. Purpose-Specific Forms (if applicable)

- Insurance claim forms, KWSP / PERKESO / SOCSO forms, lawyer letters, embassy letters etc., depending on the report use.

C) Representative (Agent / Lawyer / Insurance / Employer)

(A representative may apply on behalf of the patient when authorized to do so)

1. Application & Consent To Release Medical Information Form
2. Letter of Authorization – signed by the patient
3. Copy of Patient’s NRIC / Passport
4. Copy of Representative’s NRIC / Passport
5. Purpose-Specific Documents (insurance claim, legal request etc.)

D) For Deceased Patient(s)

(Medical report is requested after death)

1. If the requestor relationship to the patient is spouse/parent:
1. Application & Consent To Release Medical Information Form (signed by spouse/parent)
2. Copy of Death Certificate
3. Copy of Marriage Certificate (to verify relationship between the deceased and spouse)
4. Copy of Birth Certificate (to verify relationship between the deceased and parent)
5. Copy of Identification Card (I/C) of parent/spouse
6. Copy of Identification Card (I/C) of the deceased
2. If the requestor relationship to the patient is sibling/child:
1. Application & Consent To Release Medical Information Form
2. Letter of Authorisation (LOA) or Grant of Probate (for non-Muslim) or Surat Kuasa Mentadbir (for Muslim) – official
   court document stating the appointed administrator of the deceased’s estate
3. Original Consent Letter signed by the appointed administrator
4. Copy of Death Certificate
5. Copy of Identification Card (I/C) of sibling/child
6. Copy of Identification Card (I/C) of the deceased

You may submit your request via :

Standard Medical Reports and Insurance Claims should be ready for collection within 4 weeks from the time all required documents are submitted.

There are cases where requests may take longer than the stipulated completion period. Causes of delays in prompt processing include:

• Unavailability of doctors (e.g. away on leave/conference)
• Patients are still admitted/hospitalized
• Patients have multiple reports requested from several doctors
• Doctors are sessional and have limited sessions at Pantai Hospital KL (e.g. only one sessions per week)
• Only visiting/locum doctor and has no clinic at Pantai Hospital KL
• Incomplete supporting documents during application

Specialist Medical Reports or expert opinion cases may require longer processing time as a review at the Specialist Outpatient Clinic may be required after the patient has been discharged or being referred by legal firm or an open date given from clinic review.

Payment can be made using any of the following:

• Cash
• Online transfer:
  - Bank Name: HSBC Bank Malaysia Berhad
  - Account No: 201-816154-906
  - Beneficiary: PANTAI HOSPITAL KUALA LUMPUR

Applicants may receive the completed medical report through one of the following methods:

1. Collection at MRD Counter
   • NRIC or Passport is required for identity verification.
2. Email Delivery
   • The report will be sent to the email address provided in the Release Form.
3. Courier / Mail Delivery
   • The report will be couriered to the address stated in the Release Form.

1. Email :
   [email protected]
2. Business Hours:
   Monday – Friday: 9:00am – 5:00pm ( Open during lunch hour )
   Saturday: 9:00am – 01:00pm
   Sunday & Public Holidays: Closed
3. Contact No:
   +603-229889823