CH-AGH · Services médicaux

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Medical records

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Fill in this form to obtain a copy of your medical documents. Your request will be processed within 3 to 5 business days.

Full name *

Email *

Phone *

Date of birth

Patient number (if known)

Found on your health booklet

Record type requested *

Period — from

Optional — specify if needed

Period — to

Preferred format *

Copie simple Copie certifiée conforme Résumé médical Dossier complet (intégral)

Reason for request *

Minimum 10 characters.

Your data is handled confidentially.