Patient Record Request Form for Switzerland

Patient Record Request Form Template for Switzerland

A standardized form designed in compliance with Swiss federal and cantonal healthcare laws for requesting access to medical records. This document enables patients or their authorized representatives to formally request their medical records from healthcare providers while ensuring compliance with Swiss data protection regulations, particularly the Federal Act on Data Protection (FADP/DSG) and the Federal Act on Electronic Patient Records (EPRA/EPDG). The form includes necessary fields for patient identification, specific record requests, consent declarations, and processing information, structured to meet Swiss legal requirements for medical data access.

Your data doesn't train Genie's AI

You keep IP ownership of your information

Generate a Bespoke Document

1. Select your governing law:

2. Enter your key requirements:

3. Create your document to edit, review or download

Download a Standard Template

Get our Switzerland-compliant Patient Record Request Form

4.6 / 5

4.8 / 5

Alternatively: Run an advanced review of an existing
Patient Record Request Form

Let Genie AI's market-leading legal AI identify missing terms, unusual language, compliance issues and more - in just seconds.

Upload your Doc

What is a Patient Record Request Form?

The Patient Record Request Form is a crucial document used in the Swiss healthcare system to facilitate patient access to their medical records while maintaining compliance with strict data protection regulations. This standardized form is designed to be used when patients or their authorized representatives need to obtain copies of their medical records from healthcare providers. It incorporates requirements from the Federal Act on Data Protection, the Federal Act on Electronic Patient Records, and various cantonal health laws. The form ensures proper documentation of consent, identity verification, and specific record requests, while also providing information about processing times and applicable fees. It serves as a formal channel for medical record requests across various healthcare settings in Switzerland, from private practices to large hospitals.

What sections should be included in a Patient Record Request Form?

1. Patient Information: Personal details of the patient including full name, date of birth, address, contact information, and insurance number

2. Request Details: Specific information about which medical records are being requested, including time period and types of documents

3. Healthcare Provider Information: Details of the healthcare provider(s) from whom the records are being requested

4. Identity Verification: Requirements for proving the patient's identity or authority to request records

5. Declaration and Consent: Patient's formal declaration and consent for the release of medical records

6. Processing Information: Details about processing times, fees, and delivery method for the requested records

What sections are optional to include in a Patient Record Request Form?

1. Third Party Authorization: Section to be included when records are being requested by someone other than the patient

2. Urgent Request: Additional section for cases requiring expedited processing with justification

3. Research Purpose Declaration: Required when records are being requested for research purposes

4. International Transfer Details: Required when records need to be sent outside Switzerland

5. Electronic Access Request: Optional section for requesting electronic access to records instead of physical copies

What schedules should be included in a Patient Record Request Form?

1. Identity Verification Documents: List of acceptable identity verification documents and requirements

2. Fee Schedule: Detailed breakdown of applicable fees for different types of records and processing times

3. Record Types Guide: Guide explaining different types of medical records available for request

4. Privacy Notice: Detailed information about how the requested data will be handled and protected

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Cost

Free to use

Relevant legal definitions

Clauses

Relevant Industries

Healthcare

Medical Services

Hospital Administration

Private Medical Practice

Insurance

Legal Services

Healthcare Technology

Medical Research

Pharmaceutical

Relevant Teams

Medical Records

Legal Affairs

Compliance

Patient Services

Health Information Management

Data Protection

Administrative Services

Clinical Documentation

Information Governance

Patient Relations

Relevant Roles

Medical Records Officer

Privacy Officer

Data Protection Officer

Healthcare Administrator

Medical Practice Manager

Legal Compliance Officer

Patient Relations Manager

Medical Secretary

Healthcare Documentation Specialist

Clinical Administrative Coordinator

Medical Records Technician

Information Governance Manager

Find the exact document you need

No matches found.

Prison Release Form

A Swiss legal document that formalizes prisoner release conditions and obligations under federal and cantonal law.

How Cambridge United Uses Genie AI to Speed Up Player Signings and Slash Legal Costs

Generate a Bespoke Document

Download a Standard Template

What is a Patient Record Request Form?

What sections should be included in a Patient Record Request Form?

What sections are optional to include in a Patient Record Request Form?

What schedules should be included in a Patient Record Request Form?

Authors

Alex Denne

Jurisdiction

Publisher

Document Type

Sector

Cost

Find the exact document you need

Prison Release Form

Tenant Release Form

Release Of Health Information Form

Consent Form For Social (Media)

Promissory Note Release

Form Medical Record

Authorization To Disclose

Participant Release Form

Video Release Consent Form

Customer Release Form

Termination Of Account Letter

Photography Consent Form

Medical Records Form

Release Request Form

Pre Employment Background Check Consent Form

New Release Form

Digital Release Form

Release Letter Form

Protected Health Information Form

Media Permission Form

Actor Release Form

Share Medical Information Form

Records Request Form Medical

Patient Record Request Form

Physician Release To Return To Work Form

Authorization For Use Disclosure Of Health Information

Medical History Request Form

Fingerprint Release Form

Basic Media Release Form

Patient Medical Records Request Form

Medical History Consent Form

General Photo Release Form

Permission To Release Information Form

Real Estate Release Form

Release And Discharge Letter

Medical Records Request Form

Health Record Request Form

Generic Release Of Information Form

Data Release Consent Form

Permission Medical Consent Form For Adults

Genie’s Security Promise

Your documents are private:

Your documents are protected:

Organizational security:

Use Cases

Generate Legal Docs Free