More about home help

Patient Profile

Please fill out the questionnaire. Online registration allows you to save up to 20 minutes at the first visit to the Clinic. We appreciate your time!

Clinic:

Patient:

Gender:

Contact phone number and email address mail

Registration address:

Identity documents:

Do you have a legal representative?

(For patients under 18 and disabled citizens)

Don't forget to bring your passport!

By sending a request, you give consent to personal data processing