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Copy of the documentation

At IEO, certified copies of the following medical records may be requested:

  • Medical Records

    Medical records related to hospitalization

    • Simple copy
    • Copy authenticated by the signature of the Chief Medical Officer on each page

     

    Medical records related to outpatient services

    • Outpatient surgery
    • Outpatient chemotherapy
    • Outpatient radiation treatment
  • Reporting Paper

    Related to outpatient services

     

    • Diagnostic test (Mammography, Ultrasound, etc.)
    • Histology, cytology
    • Laboratory tests and HPV Test
    • Specialist visit

     

  • Diagnostic Images

    • Mammography
    • Ultrasound
    • TAC
    • Magnetic Resonance (MR)
    • Radiography (X-rays)
    • PET
    • Scintigraphy

     

In accordance with current regulations the following subjects may request clinical documentation.

  • Holder of the documentation, adult or emancipated
  • Parent of child with parental authority (equipped with state of the family)
  • Subject operating protection, receivership or administration of support (provided with proving documentation)
  • Heir (equipped with a notary act or certificate replacing the notary act, issued by the municipality).

 

  • Payment

    Payments can be made by bank transfer

            Current Account No 000500057120

            Unicredit Corporate Banking

            ABI 02008 - CAB 09432

            IBAN IT04Q 02008 09 432 000 500 057 120

            CIN Q

            SWIFT BIC code: UNCRITMMOMI (for foreign transfers)

     

    The reason for the payment to be reported is: "Clinical Documentation Request" followed by the full name of the patient to which it relates. The amount payable may be determined by referring to the table reported in the “instructions and costs” section below. 

  • Forms

    It is necessary to fill out one of the following application forms.

    • Request for Clinical Documentation by the Holder, when the applicant is the holder of the clinical documentation required.

    To the request form have to be attached:

    - A copy of a valid identity document of the applicant

    - A copy of the postal order (or the details of the bank transfer) proving the payment.

     

    • Request for Clinical Documentation by third parties, if the applicant is a parent, a party operating protection, receivership or administration of support, or an heir equipped with a notary act or certificate replacing the notary act, issued by the municipality.

    To the request form have to be attached:

    - A copy of a valid identity document of the applicant

    - A copy of the proxy/power of attorney/notary act

    - A copy of the postal order (or the details of the bank transfer) proving the payment.

     

  • SHIPMENT OR WITHDRAWAL

    If you wish for the medical records to be sent to your home address, you should complete the request form, indicating the shipping address and adding € 18.00 to the total amount paid, as contribution to the shipment costs.

    You need to send the form and the accompanying documentation to IEO in one of the following ways:

    • by Fax: +39 02 9437 9291
    • By mail to the following address:

            European Institute of Oncology

            Via Giuseppe Ripamonti, 435

            20141 Milano - ITALY

     

    Att.ne Service Acceptance - Back Office

     

     

     

    Alternatively, clinical documentation can be collected directly at the doors of Building 2 of the European Institute of Oncology, Floor 0, from 9:00 to 15:00 from Monday to Friday.

     

    Collection of clinical documentation can be made:

    • by the holder, presenting a valid identity document
    • by any other person, including the spouse, presenting:

    - the proxy form completed and signed by the holder of the clinical documentation

    - a valid identity document of the person delegated

    - the original or a photocopy of a valid identity document of the delegator.

     

     

 Find below a summary of the procedure to follow:

 

download

 


 Request for Clinical Documentation

 

     

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PARTNERSHIP

Università degli Studi di Milano Ecancer Medical Science IFOM-IEO Campus

CREDITS

Ministero della Salute Joint Commission International Breastcertification bollinirosa

© 2013 Istituto Europeo di Oncologia - via Ripamonti 435 Milano - P.I. 08691440153

IRCCS - ISTITUTO DI RICOVERO E CURA A CARATTERE SCIENTIFICO

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