SEARCH REQUEST – CONTACT FOR PATIENTS

* mandatory fields

CONTACT PROCESS
CONTACT DATA
* In which country or city would you like to be treated?
* Insurance policy
PERSONAL DATA
Date of birth
Size
Weight
TREATMENT DATA
Current diagnosis or disease
* Treatment request
Previous therapy and last treatments
UPLOAD DIAGNOSES AND FINDINGS (max. 5 MB)
More information
Confirm AND SEND YOUR REQUEST
Note:
PRIMO MEDICO only forwards the data made available by you to the medical specialists, no entitlement to medical treatment arises from our service. For acute diseases, please call a physician at your current location directly.
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