Guidance on Proxy Document Issuance · Letter of Authorization and Consent Form
This post is a migrated version of the original notice, “Guidance on Documents for Proxy Medical Care,” posted on October 28, 2025. The original guidance images are records from that time. An online document issuance service was introduced in May 2026, and relevant laws and regulations have also been revised. For current issuance methods and required documents, please refer to the guidance below and the document issuance page.
Application by the Patient
Please bring identification to verify your identity. Requirements for issuing copies of medical records, medical certificates, and other certificates vary, and some documents may require a consultation with a physician.
Application by Family Member or Proxy
Legal relatives: Please prepare the applicant's identification, documents verifying the family relationship, the patient's consent form, and other documents required for the applicable case.
General proxies: The applicant's identification, a copy of the patient's identification, and a consent form and letter of authorization signed by the patient are required.
For patients under 14 years of age, minors who have not been issued identification, or cases involving death, unconsciousness, missing persons, or incapacity, separate verification documents and legal representative requirements apply.
If you let us know your relationship to the patient and the document you wish to receive at 02-6958-7070, you can receive guidance on what to prepare before your visit. Download the original letter of authorization and consent form templates from the attachments.
Current document issuance guidance
