Medical Records Affidavit

Medical Records Affidavit Template for Singapore

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Key Requirements PROMPT example:

"I need a Medical Records Affidavit for Singapore General Hospital to verify the authenticity of patient records from January 2025 to March 2025, which will be used in an insurance claim process for a workplace injury case."

Document background

The Medical Records Affidavit serves as a crucial document in Singapore's healthcare and legal framework, used when formal verification of medical records is required. This document is particularly important in legal proceedings, insurance claims, or when transferring medical information between healthcare providers. The affidavit must comply with Singapore's stringent healthcare data protection laws and is typically executed before a Commissioner for Oaths. The document includes detailed information about the records being verified, their source, and the basis for the declarant's knowledge of their accuracy.

Suggested Sections

1. Declarant Information: Personal details of the person making the affidavit including name, NRIC/passport number, occupation and address

2. Patient Information: Details of the patient whose medical records are being addressed, including full name, identification number, and date of birth

3. Purpose Statement: Clear statement of the specific reason for the affidavit's creation and intended use

4. Records Description: Detailed description of the medical records being referenced, including dates, types of records, and healthcare institutions

5. Verification Statement: Formal declaration of truth and accuracy of the statements made in the affidavit under penalty of perjury

Optional Sections

1. Consent Declaration: Section declaring that proper patient consent has been obtained for the disclosure of medical records

2. Capacity Statement: Declaration of legal authority to make the affidavit when the declarant is not the patient

3. Electronic Records Statement: Specific declarations regarding the authenticity and handling of electronic medical records

Suggested Schedules

1. Medical Records Index: Comprehensive list of all medical records referenced in the affidavit, including dates and document types

2. Authorization Documents: Copies of relevant authorizations, powers of attorney, or court orders granting authority

3. Consent Forms: Attached copies of patient consent forms and related documentation

4. Records Certification: Official certification from healthcare providers confirming the authenticity of the medical records

Authors

Alex Denne

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

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Healthcare
Insurance
Legal Services
Government Healthcare

Relevant Teams

Medical Records
Legal
Compliance
Operations
Administration

Relevant Roles

Medical Records Administrator
Healthcare Compliance Officer
Legal Counsel
Claims Manager
Medical Director

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Let's create your Medical Records Affidavit

Authors

Alex Denne

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