• Patient data
  • Appointment request
  • Summary of your appointment

* Required fields

Personal data

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The field must have the following format: DD/MM/YYYY
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* Required fields

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Patient’s Data

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Passport Country
Document
Name
Surname
Second Surname
Date of birth
Gender
Email
Country
Province
Town
Town
Adress
Floor
Number
Post Code
Landline Phone
Cell Phone

Appointment request

Change

Type of request
Headquarters
Do you have health insurance?
Insurance company
Policy Type
Area
Specialty
Specialty
Disease or problem
Disease or problem
Disease or problem
Specialist
Specialist
Specialist
Appointment date
Appointment time

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Thank you for your trust in the Clinic

We have noted your request.

Puede acceder al Patient Area to manage your appointments.

Appointment detail


Headquarters
Specialty
Specialty
Physician
Physician
Date of appointment
Appointment time

For your peace of mind, please check with your insurer about the coverage of your policy before starting medical care.