Register

You can register as a new patient by filling in and sending the form below. You will then receive a login for the digital counter by email. This digital counter contains a number of forms with information about the first appointment, which treatments we offer, an informed consent and medical history. As soon as you have read and/or signed all these forms, we will contact you by telephone as soon as possible to schedule an appointment. If you have any questions, you can ask us directly during the telephone consultation. Please register for your first appointment within the system. If you would like to register a family member using an email address already in our system, you can do so via the digital portal.

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Phone

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Name*

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Zip code*

House Number*

House Number addition

Phone*

Email*

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