Application for hospitalization certificate and medical certificate

Persons with life insurance or post office life insurance, and who would like to to receive a hospitalization certificate or medical certificate during their stay at the hospital, we will do our best to provide it by the time of discharge from this hospital.

Since certification takes some time, please notify us soon after hospitalization. 
If you wish to receive a hospitalization certificate or medical certificate after hospital discharge, please apply to the address below.

※If you would like the certificate to be sent by mail, please prepare a return, self addressed, stamped envelope.

※If you apply by postal mail, please send a document with (1) your name, date of birth, period of certification, (2) certificate or medical certificate, and (3) a self-addressed, stampled envelope to the following address. 
Please make payment for the certificate fee by bank transfer afterwards.

Contact to:

Medical Support Section Admission/Discharge Reception TEL:0166-69-3011
(The counter is usually very crowded in the morning. If possible, please try to contact us in the afternoon.)

Send to:

Postal Code 078-8510
Midorigaoka Higashi 2-jo 1-1-1, Asahikawa
Asahikawa Medical University Hospital Medical Support Section Admission / Discharge Reception

Reference

Hospitalization certificate or medical certificate to be submitted to a life insurance company
6,000 yen per case (6,600 yen including tax)