Medical Reports & Claims

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your treatments


The Medical Report Unit processes medical report management, including insurance claims and others.

Applicant of Medical Report

  • Patient
  • Parent / Legal Guardian (patient below 18 years)
  • Next of Kin i.e spouse, son, parent (deceased patient)
  • Appointed agent (insurance, legal firm & others)
  • Authorized Government Agency (PDRM, KKM, SPRM)

Application & Consent form for Medical Report

Purpose Applying for Medical Report

  • Insurance Claim
  • Legislation
  • Medical Board
  • Inquiry
  • Review and Others

Application & Consent form for CD and Film


You can apply for your medical reports and claims by the following mode of requests:

Walk In

You can visit us at:

Medical Report Counter,
Ground Floor, Block B


  • Please download IJN application.
  • Make payment (for applied application only)
  • Scan and email IJN application form, formal application form and receipt payment to


  • Please download IJN Application Form or IJN Borang Permohonan
  • Post to:
    Health Information Management Services
    Institut Jantung Negara
    145, Jalan Tun Razak,
    50400 Kuala Lumpur.

**Email and Post will be entertain within 3 working days from the date received.
**Application will be processed after we received complete form and payment clearance (applied application only).

Operating Hours
Monday to Thursday
8.00 AM- 4.30 PM
8.00 AM – 12.30 PM
2.30 PM – 4.30 PM(Friday break 12.30 PM – 2.30 PM)
Saturday, Sunday, Public Holidays Closed

For any enquiry, please do not hesitate to call us at 03-2617 8217 / 8219  or
email to us at


Medical Report (IJN Format)

Fee (RM)
1. Attending Physician Statement Form by Consultant 120
2. Attending Physician Statement Form by Clinical Specialist 100
3. Attending Physician Statement Form by Consultant 100
4. Insurance Claim Form by Clinical Specialist 80
5. EPF Incapacitation 100
6. EPF Health Withdrawal 50
7. SOSCO 50
8. Hajj Appeal letter/Hajj Book FOC

Medical Report (Form Prepared by External Party)

Fee (RM)
1. Full medical report by Consultant 200
2. Full medical report by Consultant – with doctor’s opinion 250
3. Full medical report by Consultant with Second Opinion (Non IJN Patient) 570
4. Full medical report by Clinical Specialist 100
5. Correspondence letter (Supporting letter is required. Download here (BM / EN)) FOC
6. Full medical report request by Authority Government bodies (PDRM, MOH, Court) FOC

Medical Report (Additional Charges)

Fee (RM)
1. Administration Fees (Applicable for above MR Request for item 1-4 and 7-13) 20
2. Self-Collect FOC
3. Email FOC
4. Postage – Peninsular Malaysia 10
5. Postage – East Malaysia 16
6. Postage – International Subject To Courier Charges

Medical Report (Miscellaneous)

Fee (RM)

per copy

1. Copy of Report
(i.e. Referral letter, investigation report, discharge summary, Medical Certificate (MC), Blood test, Operation report, Echocardiogram)
2. Copy of CD (Angiogram, MSCT, X-ray) 18
3. Copy of CD (ECHO) 25
4. Copy of Film (X-ray) 20


Medical Reports & Claims

How to apply for Medical Report?

You can request by:


  • Walk in to Medical Report Counter @ IJN
  • Email to
  • Post to Health Information Management Services, Institut Jantung Negara
  • IJN portal

When do I submit the form?

After completion of your visit to the Outpatient Clinic or after discharge from the ward.

Is there any payment or fee for Medical Report?

Payments are subject to the type of application. Please refer Medical Report Fees for more detail.

What is mode of payment for Medical Report?

Payment can be made to any of the following:

  1. Cash
  2. Online transaction – account detail
    • Bank – Maybank
    • Account number – 5-14093-0000-23
    • Swift code –MBBEMYKL (Pease submit via email the scanned copy of bank transfer receipt to
  3. Debit or credit card

Who can apply for a Medical Report?

The requestor must be one of the following:

  1. A Patient aged 18 years and above.
  2. A parent or legal guardian can apply for patient who is a minor (17 years old and below).
  3. Interested third parties (i.e. insurance company and employer) with patient’s consent.
  4. Next of Kin of disabled / deceased patient’s. Please refer IJN List of Immediate Next of Kin.

IJN List of Immediate Next of Kin for disabled (unable to give voluntary consent) or deceased patient.

  1. The Next of Kin could be any one of the following who is available:
    • the patient’s spouse;
    • the patient’s child;
    • the patient’s parent;
    • the patient’s sibling;
    • the patient’s grandparent;
    • the patient’s grandchild;
    • An adult immediately related to the patient by marriage.
  2. The criteria for Immediate Next of Kin must:
    • be at least 18 years of age (adult),
    • have been in contact with the patient during the preceding 12 months,
    • have no dispute with the patient,
    • be willing to comply with the duties,
    • Not misuse the patient’s record.

I’m a family member of the patient but not allow to request the medical report. Why?

We only allow the request from Next of Kin as registered in our system.

Can the family member or insurance agent or representative request and collect the report on my behalf?

Yes, as provided in the application form.

How long does it take for the doctor to complete my medical report?

The timeline for Report Completion is within 28 working days from the date we receive your complete request. Delay in medical report completion may be the result of:


  • The patient has upcoming clinic appointments
  • The patient has been warded after submitting the application
  • The patient’s file being used by other departments (for various reasons)
  • Patient has multiple reports requested from several doctors
  • The doctor is away on leave.

Can I request for a copy of investigation result?

Yes. You will be receive a copy of investigation result within a week from the date apply.

Will Medical Report Unit provide all the necessary forms for me to claim? I.e. insurance claim form, PERKESO, EPF etc.

No. Medical Report Unit will not provide any form. You should request for the form(s)to be completed by our doctor from respective organizations. We will not be held responsible if you sent us the wrong form(s).

How will I receive the Completed Medical Report?

You can collect the report personally at Medical Report Counter or request the report to be posted at the address you have provided.

If I wish to cancel the application, can I get the refund?

Yes, we allowed for refund but only for the medical report fee and postage (if any). The administration fee will not refund back as we already processing your application.

If I wish to cancel the postage and collect the report, can I get the postage fee back?

Yes, you can get the postage fee back by providing the original receipt for verification.

What will happen if the application form submitted there is an attempt to cheat?

During verification process, if there any discrepancy was found, we will on hold/reject the application and the payment will not be refund back to requestor..

My last visit to IJN is 10 years ago. Do I need an appointment with a doctor to get the latest medical report??

Yes, you should get the latest appointment so that the doctor can assess the latest condition and can advise what is better for you. After that, you can request for latest medical report. According to IJN policy, if patient didn’t come to IJN after 7 years from last visit, the file will be disposed.

I need a simple letter from my doctor confirming that I am an IJN patient, can you explain the process?

First, we need to know the purpose of the letter (If the request for comprehensive detail, we advise to apply for medical report).

How much does it cost for the letter?

There is no charges applied for now. If request for copy of the report, the will be charges of RM10.

Can a relative ask a question regarding the patient's wellbeing?

No. only can be release with patient consent.

I am a Govt Employee/Pensioner, is my medical report charge covered by Govt?

No, it is not covered by the Govt.

I am an IJN patient and about to go for general surgery in. My anaest/surgeon is requesting a record of my condition in IJN. How do I go about it?

Please provide us the memo/notes from the anaest/surgeon so that our doctor can prepare the reply and please fill in our application form as well.

I forgotten my MC slip during discharged, can I get a copy from HIMS?

There will be charges of RM10 for MC copy.