Medical Record

Medical Record

Document Submission

Para solicitar su historia clínica, por favor diligencie el formulario correspondiente y adjunte los documentos requeridos según los requisitos establecidos.

Requirements according to the type of applicant

If the request is made by the patient, you must attach:

  1. A legible copy of the patient’s identification document.
  2. Request form F-GD-004, duly completed and signed.

If the request is made by a family member, representative, guardian, or third party authorized by the patient, you must attach:

  1. A legible copy of the authorized person’s or representative’s identification document.
  2. A legible copy of the patient’s identification document.
  3. Request form F-GD-004, duly completed and signed.
Important: Ensure that all documents are in PDF or image format (JPG, PNG) and are clearly legible.

Accepted formats: PDF, DOC, DOCX, JPG, PNG

The response time for your request is as follows:

  1. Clinical Record: THREE (03) BUSINESS DAYS after receipt of the duly completed request.
  2. Please note that the reading of diagnostic images has a term of THREE (03) BUSINESS DAYS by the corresponding professional. Consequently, after that period, the applicant may submit their Clinical Record request with the diagnostic readings.

In case you encounter difficulties sending the documents:

Follow the steps below to complete and submit your clinical request.

  1. Download the request form by clicking the button below:
  2. Complete the downloaded form and attach it together with the requirements..
  3. Send the form and documents to the email archivo@barraquer.com.co.