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MC Slotervaart File copy - by external health care provider
Use this form to request a copy from the medical records of a patient at Slotervaart Medical Center for the progress of medical care.
Request file copy
- complete the form below;
- Attach a written consent with patient signature.
- Or attach a printout of fiat exchange of data with external health care providers from your EHR.
- Continuing treatment (taking over file due to circumstances) is exempt from duty to provide signed consent.
Process and receipt
The Slotervaartloket is managed by Team Uitlevering Dossier of the UMC Utrecht.
The copy will be sent to you via secure email. Please allow up to 4 weeks for delivery. Is your request urgent? Please state this explicitly in your request.
Contact
If you have a question about the application form, email us at mcslotervaartdossier@umcutrecht.nl or call 088 - 75 58 801 (Delivery Dossier Team).
For reasons of patient privacy, we are unable to provide medical information by telephone. We ask for your understanding.
Request form
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