Medical Documents

You can apply at the Documentation Counter for any standardized forms, such as those needed when sending a premium invoice to an insurance company. If you need a certificate that does not fit a standardized format, such as a document proving that you do not have a specific disease, please speak with your physician during your consultation.

Where To Apply

Hospital-Specific Forms, Required Documents for Transfer, etc.

Inpatients

Please inquire at the ward's staff station.

  • Please apply early enough for records to be prepared and issued by your scheduled discharge date.
Post-Discharge & Outpatients
Please consult with an outpatient physician.

Other documents

For documents requested by your life insurance provider, or those related to public funds, please inquire at the Documentation Counter on the 2nd floor of Building 2. (8:40 a.m. to 7:00 p.m. on consultation days)

Floor map

Documentation Counter

03-5363-3531
(Telephone reception time: 8:40-17:00 on business days)

Documents handled by the hospital
  • Documents requested by life insurance companies, medical certificates required when claiming compulsory automobile liability insurance, and documents related to long-term care insurance.
  • Documents related to public funds. (Public assistance, workers' compensation, tuberculosis, medical rehabilitation services for disabled persons, rehabilitative treatment for disabled children, pollution, etc.)
  • Please note that some documents can only be issued after a follow-up consultation. In such situations, you will be contacted by the hospital.
  • Locations differ depending on document type and time of application. For detailed information, please contact the Documentation Counter.
  • Patients are responsible for confirming and ordering any required life insurance specific forms.
  • Applications can only be processed at the Documentation Counter. No applications are accepted online or by phone or mail.
  • For identity verification, please bring valid ID (e.g., driver's license, health insurance card).
  • Applications are generally made according to department.
  • Applications made by anyone other than the patient require a proxy consent form.

    Commission letter(Japanese)

Receiving Documents

Hospital-specific documents
Hospital-specific documents are generally issued before the end of your stay, but can be prepared upon request.
Other documents will be sent to you basically by mail.
Documents may also be picked up at the Documentation Counter on the 2nd floor of Building 2 (8:40a.m. to 7:00p.m. on consultation days). Please inquire at the counter when submitting your application.