• 2-14, Jalan Nelayan 19/B, Seksyen 19,
  • Emergency 03 5543 4145
  • General Line 03 5543 4000
Appointment

Medical Report Application & Submission Guide

Request Your Medical Report with SALAM

Welcome to the Medical Records Unit. We facilitate medical report applications for patients, next-of-kin, and authorized third parties for purposes such as:

  • Insurance claims
  • Legal matters
  • Employment-related matters
  • Personal reference

Patients may now apply for a medical report through 3 options:

1. Walk-In – Patients may proceed to Medical Records Unit at our Hospital (Level 5) 
2. Download Form (NEW) – Patients can download, complete, and submit the application form either by email or walk-in.
3. Online Form (NEW) – Patients can fill in and submit the application form directly online, including uploading supporting documents and proof of payment.

Please read the guidelines below before submitting your application.

Apply Online
Download Form

Services Provided

The Medical Records Unit facilitates the processing of the following services:

  • Medical report requests – reports are prepared by the attending doctor/consultant
  • Completion of insurance and statutory forms (e.g., PERKESO, KWSP, EPF, vaccination) – forms will be filled out by the respective doctors
  • Retrieval of investigation results such as laboratory, radiology, or other diagnostic tests
  • Reissuance of immunization records and medical certificates (MCs)
  • Processing of clarification or explanatory letters, if officially requested

⚠️ Please note that all medical content is prepared and signed by the attending physician. The Medical Records Unit only coordinates the process and ensures proper documentation.

🕘 Operating Hours

  • Monday – Thursday: 8:30 AM – 5:30 PM
    (Lunch Break: 1:00 PM – 2:00 PM)
  • Friday: 8:30 AM – 5:30 PM
    (Lunch Break: 12:30 PM – 2:30 PM)
  • Saturday, Sunday & Public Holidays: Closed

📍 Location & Contact

Medical Records Unit, Level 5
SALAM Shah Alam Specialist Hospital
2-14, Jalan Nelayan 19/B, Seksyen 19,
40300 Shah Alam, Selangor

📞 Telephone: 03-5543 4000 (Extension: 4020)
📧 Email (for applications): mr.ssa@salam.com.my
(Please CC: wanzailani@salam.com.my for reference purposes)

Consent (Required for Under 18 Medical Report Application)

  • Written consent from the patient is required for any request, if the patient is:

    • Under 18 or mentally incapacitated → Consent must be given by a parent or legal guardian
    • Deceased → Consent must be provided by next-of-kin or legal representative

    All applications must be accompanied by:

    • Completed application form
    • Consent form (if applicable)
    • Copy of applicant’s NRIC/Passport
    • Supporting documents relevant to the case
    • Proof of payment

Online Medical Report Application

Option 1: Download Form

Patients may apply for a medical report online through the following steps:

Step 1: Access the Application Form

Step 2: Complete the Form

  • Fill in the form at your convenience (at home or elsewhere).
  • Ensure all details are complete and the form is duly signed.

Step 3: Submit the Application

  • By Email → Send the completed form, consent form, supporting documents, and proof of payment to: mr.ssa@salam.com.my
    (Please CC: wanzailani@salam.com.my for reference purposes)
  • By Walk-In → Submit the completed form together with supporting documents at the Medical Records Unit counter, Level 5 during office hours.

Step 4: Payment

  • Walk-In Submission → Payment can be made at the Outpatient Billing Counter (cash, debit, or credit card).
  • Email Submission → Proof of online transfer payment must be attached together with the application form and sent to mr.ssa@salam.com.my (CC: wanzailani@salam.com.my).

📌 This process is designed to minimize waiting time at the counter. Patients only need to submit the completed application and payment without filling in forms on-site.

Option 2: Application via Online Form

  • Patients may apply for a medical report online through the following steps:

Step 1: Access the Online Form

Step 2: Complete the Application

  • Fill in all required patient details directly in the online form.
  • Ensure all information is accurate and complete before proceeding.

Step 3: Upload Required Documents

Upload supporting documents such as:

  • Copy of Identification Card / Passport
  • Consent form
  • Insurance Requirement Form (if applicable)

    If the application requires a Doctor’s Form, patients may:

  • Download the Doctor’s Form from the same page
  • Have it completed by the attending doctor
  • Upload the completed Doctor’s Form back into the online form

Step 4: Payment

  • Upload proof of payment for online transfer directly in the form
  • Alternatively, choose Walk-In Payment at the Outpatient Billing Counter (cash, debit, or credit card)
Step 5: Submit Application
 

This option is fully online, allowing patients to complete and submit the application without the need for email or counter submission. 

Required Documents

  1. Patient
  • NRIC or Passport
  • Completed application form
  • Supporting medical documents (if any)
  • Proof of payment
  1. Parent/Guardian (for minors)
  • Patient’s Birth Certificate / NRIC / Passport
  • Parent/Guardian’s NRIC or Passport
  • Statutory Declaration (if required)
  • Supporting documents
  • Proof of payment
  1. Representative (Spouse, Next-of-Kin)
  • Consent letter from legal heirs
  • NRIC of representative and legal heirs
  • Death Certificate (if patient is deceased)
  • Relevant supporting documents
  • Proof of payment
  1. Agent (Insurance, Lawyer, etc.)
  • Patient’s NRIC or Passport
  • Agent’s NRIC or Passport
  • Consent letter from patient or legal heirs
  • Death Certificate (if applicable)
  • Supporting documents
  • Proof of payment

Processing Time

Reports are typically completed within 14 working days after receiving full documentation and payment.

Processing time may be delayed if:

  • The doctor is on leave or unavailable
  • The patient has upcoming follow-ups
  • The patient is still hospitalized or under treatment
  • The request involves multiple specialists
  • Documentation is incomplete

You will be notified once the report is ready.

Medical Report Fees

Type of Report Specialist Medical Officer (MO)
Medical Report for Lawyer (Typed/Written)
RM 300
RM 300
Medical History / Letter Head
RM 150
RM 100
EPF Form
RM 80
RM 50
Reissue of Immunization Record
RM 20
RM 20
Reissue of Immunization Book
RM 5
RM 5
Photocopy of Medical Certificate
RM 10
RM 10
Photocopy of Lab / Radiology Reports
RM 5
RM 5
Police / Military / Gov Report (by officer request)
F.O.C.
F.O.C.
Clarification / Explanatory Report
F.O.C.
F.O.C.

⚠️ All medical report charges exclude an RM 5 registration fee.

⚠️ Fees are subject to change. Additional charges may apply for complex requests.

Courier Service Charges

Courier Option Fee
Standard Courier (Local – City-Link)
RM 10

⚠️ All medical report charges exclude an RM 5 registration fee.

⚠️ Fees are subject to change. Additional charges may apply for complex requests.

Payment Methods

You may pay via:

  1. Cash / Debit / Credit Card (at the hospital)
  2. Online Transfer to:
    • Bank: Maybank
    • Account Name: SALAM MEDICAL CENTRE SDN. BHD.
    • Account Number: 5 1 2 2 7 7 5 0 4 7 2 3

📧 Please email your payment receipt to: mr.ssa@salam.com.my
(Kindly CC: wanzailani@salam.com.my for reference purposes)

Report Collection Options

Once your report is ready, you will be notified by phone or email.

  • Option 1: Self-Collection
    Collect your report at the Medical Records Unit, Level 5 during office hours.
  • Option 2: Courier Delivery
    We will deliver the report to the address provided in your application form. (Courier fee: RM 10)