>>Request of modification or cancellation of appointment

AppointmentPlease notify us at least 24 hours in advance if you are unable to keep your appointment so that the time slot can be allocated to another patient. Otherwhise a 30 € fees will be charged to you.

To cancel an appointment, you can fill in and send the online form below or you alternatively may use our free phone line : 0800/35.088. This phone line is also valid for canceling an admission.

Please fill in all fields marked with an asterisk *.

Not to fill in !

Last name *
First name *
Birthdate (dd/mm/yyyy) *
Telephone (preferably GSM) *

Current appointment is scheduled on at h in *

Name of the doctor / consultant

Your request * :
Change of date

Comments :

>>Appointment request form / Electronic list of consultations and consultants.