Medical: templates and forms

5 forms available to fill out or download.

Claim for reimbursement of medical expenses from a health insurer (Spain)

A Spanish letter, in Spanish, for a person covered by a private health insurance policy with expense reimbursement in Spain who has paid for a consultation, a test or a treatment and wants back what the policy covers. It claims the refund from the insurer under Article 105 of the Spanish Insurance Contract Act, lists the care, the invoices, the amount and the IBAN, and asks for any refusal to be explained in writing. Send it by certified post, burofax or the insurer's customer area. It holds health data, so it is sold blank and filled in by hand.

Spain
Application
Medical
€1.381 page

Request for access to and a copy of the medical record (Spain)

A Spanish letter, in Spanish, for a patient who wants to see and copy their medical record in Spain, for their representative, or for a relative of a deceased patient. It exercises the right of access under Article 18 of Spanish Law 41/2002 and Article 15 of the GDPR before a hospital, health centre or private clinic: it names the documents, the period and how the copy is to be delivered, and recalls the one-month deadline and that access is free. Hand it in at the patient or admissions service or send it by certified post; to a public centre, also through a public registry. It holds health data, so it is sold blank and filled in by hand.

Spain
Application
Medical
€1.382 pages

Complaint to a hospital's patient service (Spain)

A Spanish written complaint, in Spanish, for a person treated at a public hospital or health centre in Spain, or a relative, who wants to complain in writing about the care: an excessive wait, a cancelled appointment, poor treatment, a lack of information. It is addressed to the patient service (servicio de atención al paciente), asks for the facts to be looked into and for a reasoned answer within the period set by the region's rules. It is not a claim for compensation. File it at the service itself, at any public registry office, at a post office or online. It holds health data, so it is sold blank and filled in by hand.

Spain
Complaint & Appeal
Medical
€1.381 page

Advance healthcare directive (Spain)

For anyone who wants to set down their values and decisions about the treatments they accept or refuse, in case they cannot express them one day, and to name a representative to the healthcare team. Each Spanish autonomous community regulates this document and has its own registry and often a free model: if there is one, you may use it. It is sold blank and filled in by hand, because it holds health data. It is formalised before a notary, witnesses or the registry, as your community allows, and entered in the regional registry. In Spanish.

Spain
Affidavit
Medical
€1.382 pages
Fill online

Authorisation to take a minor to medical appointments (Spain)

For parents who cannot take their child to the paediatrician, a check-up, a vaccination or A&E and ask a grandparent, carer or summer camp to do it. Many Spanish health centres and hospitals have their own free authorisation form: if the centre asks for it, use theirs. This authorisation lets the carer accompany the child and receive the professionals’ instructions; health decisions remain the parents’. Both parents sign it and the authorised person carries it with their ID. In Spanish.

Spain
Consent
Medical
€1.382 pages

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