Medical: templates and forms
4 forms available to fill out or download.
Access to the civil invalidity assessment file (Italy)
An Italian request, in Italian, for access to documents (articles 22 ff. of Italian law 241/1990) sent to INPS or the local health authority to see or copy the civil invalidity, handicap or disability assessment (verbale) and the medical file of the procedure: for the person concerned, a parent or guardian, a delegate or an heir. The verbale can also be downloaded free from INPS’s online services. No stamp duty is due to view the file or for plain copies; certified copies need a 16 € stamp unless an exemption applies. Send it by PEC or by hand. Sold blank and filled in by hand.
Complaint to the patient relations office of an Italian health authority (Italy)
An Italian written complaint, in Italian, to the public relations office (URP) of a local health authority (ASL), a hospital trust or an accredited facility, about a poor service or conduct in care: the patient or a relative gives the ward, the date and the facts and asks for checks and a written answer within the time set by the authority’s service charter. Many authorities have their own free complaint form. Send it by PEC, registered post with proof of receipt, or by hand. It holds health data, so it is sold blank and filled in by hand.
Request for a copy of the medical record (Italy)
An Italian letter, in Italian, to the medical director’s office of a hospital or clinic asking for a copy of the medical record (cartella clinica) and other health documents: the patient, a delegate, a parent or guardian, or an heir gives the stay or treatment, the documents wanted and the format. The facility must hand them over within seven days (art. 4 of Italian law 24/2017). Many facilities have their own form or a free online service. Send it by PEC, registered post with proof of receipt, or by hand. It holds health data, so it is sold blank and filled in by hand.
Claim for medical expenses to a supplementary health fund or insurer (Italy)
An Italian letter, in Italian, from a member of a supplementary health fund, a mutual fund or a health insurance policy, claiming back visits, tests, treatment or hospital stays already paid: it lists the invoices and prescriptions enclosed, gives the IBAN and asks to be told in writing of any missing documents. It is for funds that accept claims by post or PEC, or to chase a claim that has stalled; if the fund has its own members’ area or form, use those. It holds health data, so it is sold blank and filled in by hand.
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