Medical Records

Application for Retrieval of Medical Records
The registration and medical records department at Raphael Hospital deals with the collection, maintenance and management of all medical records created at Raphael Hospital, and the department is also responsible for retrieving medical information for the patient, in accordance with the Patient Rights Law.

Types of Requests
• Self-application: A patient who underwent an operation at Raphael Hospital and is now discharged who is requesting medical information related to the procedure, must send the hospital’s medical records department an application form for medical records, confidentiality waiver form and a photocopy of their ID card + addendum, in accordance with the guidelines outlined below.

• Application from a lawyer: Lawyers are welcome to send applications for medical records through post/fax/email, including Medical confidentiality waiverand a power of attorney from the patient. In the case of a medical records collection company, a letter of appointment from the applicant from the company is also required.

• Application for medical records for a deceased patient: medical records for a deceased patient will only be delivered to first-degree relatives or to heirs registered in an inheritance order, or will execution order. If an inheritance order has not yet been issued, a form declaring that all heirs are notified of the application is required. The form must be signed by a lawyer, and the heir requesting the records must send an application and a copy of their ID, or according to a court order.

• Application for records for the purpose of continued treatment: a doctor requesting the medical records for the purpose of continued treatment, must send an application using an official letter by email/fax/post. The application must be signed by the doctor and stamped by the clinic and include the patient’s full name and his/her ID number.

Submitting an Application
• fill out a form for retrieval of medical records. Download
• Confidentiality waiver Download
• Patient ID + addendum

Submission of application

• elianl@raphaelhospitals.co.il
• Fax: 03-7752068
• Registered post: Raphael Hospital, Atidim Park, Building 3. PO BOX 58162, Tel Aviv, 6158101

Collection of documents

• Self collection during office hours: Sun-Wed 9.00-14.00 at the reception, 1st floor, at the hospital entrance.
• Through registered post sent to the address on the patient’s ID or to the lawyer’s office address.
• Through a messenger / guardian: required to show a power of attorney upon collection, as well as a copy of the patient’s ID and the messenger / guardian’s ID.
• A natural guardian (parent to children under 18) must send an application and include a copy of their ID with the addendum showing the child’s name. When the application deals with a patient who is legally incapacitated, you must attach healthcare power of attorney and a copy of the ID card.

Rates

• Self application up to 3 months from the date of the procedure - free of charge.
• Self application later than 3 months from date of procedure - 100 NIS (based on the ministry of health pricelist)
• Medical records collection company / law firm - 100 NIS (based on the ministry of health pricelist)

For additional inquiries and information
Elian Levitan: elianl@raphaelhospitals.co.il
Office hours: Sun-Wed 9.00-14.00 at the reception, 1st floor, at the hospital entrance.
Customer service: 03-3767449