Quick appointment

Refer a Patient

We take care of a quick appointment and can usually perform all necessary neurological examinations on an outpatient basis and within a few days. For a referral, please either contact our secretary’s office or use the following online form (* mandatory fields). The transmission of the data is encrypted and secure.

Select Location*

Patient Information

First Name * Last Name *

Date of Birth * Address *

Postal Code * City *

Phone/Mobile * Email

Health Insurance Insurance Number

Referring Physician

Clinic *

Phone Email*

Reason for Referral

Referral to Neurology Neurosurgery Neuropsychology

Medical Clarifications Required: *

We process your data exclusively to process your request or order. For more information on how we handle personal data, please see our privacy policy.

Additional documents

Please send us relevant documents (reports, findings, imaging results, etc.) separately via email, fax, or post if the patient does not bring them themselves.

You can find an overview of all contact information here.