Contact Form

<br> Please note that we require the following documents in addition to the filled contact form. <strong> Kindly understand that we cannot process requests if relevant documents are missing.</strong> Before you start filling our contact form we recommend that you collect all relevant documents:</li> <br> <br> <ul> <li>Up-to-date <strong>medical reports </strong><strong>in English or German</strong> (not older than 3 months).<strong> </strong></li> <li>Some inquiries require <strong>protocols of previous treatments or images</strong> (MRI,CT,...).<br /> (Please note that images should be provided in DICOM-Format. For the upload of your images we can send you a link to our dedicated platform)</li> <li>A <strong>passport copy of the patient</strong>.</li> <li>If you are not the patient yourself, but are requesting for someone else, a <strong>signed release of confidentiality</strong> ist required. We provide the document here for download and ask you to send it with all the other documents.</li> <br /> <ul/> <br> <strong>Download our document „Release from confidentiality“</strong><br><br> <a title="Opens internal link in current window" class="btn btn-default" target="_blank" href="/fileadmin/kliniken/international/Dokumente/Release_from_confidentiality_English_German.pdf">English/German </a> <br> <br> <a title="Opens internal link in current window" class="btn btn-default" target="_blank" href="/fileadmin/kliniken/international/Dokumente/Schweigepflichtentbindung_arab_dt.pdf">Arabic/German</a> <br> <br> <a title="Opens internal link in current window" class="btn btn-default" target="_blank" href="/fileadmin/kliniken/international/Dokumente/Schweigepflichtsentbindung_russ_dt.pdf">Russian/German</a> <br> <br> <strong>When choosing the documents you share with us, please keep in mind that we cannot handle documentation that is too extensive and/or outdated.</strong>