Medical record request

We make available the requirements and/or documents you need to submit the request a simple copy of a medical record

Take into account the following considerations:

The documents must be sent to the email:

If the patient is a minor, the application must be signed by both parents with a copy of the identity document of the minor and the parents. If the parents are separated or divorced, the request must be in person at the clinic in the customer service area.

If the patient cannot personally carry out the procedure, he or she must send a simple power of attorney with the name of the person authorized to carry out the procedure, attaching copies of his / her ID and of the applicant.


  • The cost per copy of the medical record is S/ 0.50 per sheet
  • The cost per foliated copy is S/ 1.00 for each numbered page
  • The cost per medical auditor report is S/ 80.00
  • The cost per treating Physician report is S/ 120.00

Duration of validity:

The copies will remain available within a period of 30 days, after this time, the copies will be eliminated.


Ricardo Angulo Street 192 / 2nd floor – Medical records area

Telephone center:

(511) 224·2224 / (511) 224·2226 extension: 1487

Service hours:

Monday to Friday: 9:00 at 17:00
Saturday: 9:00 a 12:00

Note: More details of the considerations are in the downloadable document