Formulário · Português
Formulário de Credenciamento
Form used for certifying or accrediting a medical condition for administrative purposes.
- Form type
- nin
- Language
- Portuguese (Português)
- Archive source
- AMDA-IMIC Japan forms library, 2013–2024
About This Form
This page documents the Formulário de Credenciamento as provided in Portuguese through AMDA-IMIC's multilingual forms library. The form is used for: form used for certifying or accrediting a medical condition for administrative purposes..
Administrative accreditation of a medical condition is required in Japan for accessing certain benefits, exemptions, and insurance reimbursements. The certification establishes the existence of a specific condition in a format recognized by employers, insurers, or municipal agencies. Foreign residents in Japan encounter this process when applying for disability recognition, welfare benefits tied to health status, or occupational disease classification under the labor insurance framework.
For the original administrative forms in active use, contact the relevant Japanese institution directly — a hospital, employer, local health center, or labor bureau — depending on which form is needed. This reference documents the structure and purpose of the forms as they were used during the 2013–2024 period when AMDA-IMIC was operating.
Form Sections and Fields
The following sections and fields appear in the Portuguese version of this form. Field labels are rendered here in English for reference; the original form presents them in Portuguese (Português).
- Applicant full name and date of birth
- Nationality and residence address
- Insurance type and certificate number
- Condition to be certified (Japanese and romanized name)
- ICD-10 classification code
- Onset date or diagnosis date
- Purpose of accreditation (insurance / welfare / employer / other)
- Certifying physician name and license number
- Name and address of certifying institution
- Date and official institution seal
How to Obtain This Form
The forms documented on this site were originally distributed by AMDA-IMIC through its consultation service and language-specific subdomains. Since the center closed in 2024, the forms are no longer distributed through that channel. Equivalent forms for current use are available from the relevant Japanese institution: municipal health centers issue administrative forms, hospitals provide their own registration and appointment materials, and the Labor Standards Inspection Office supplies labor insurance documentation.