Important:

  • Here you can pre-order referrals and pick them up at the doctor's office the next working day.
  • If the postage costs are reimbursed, we will send you your referrals by post.
  • The prerequisite is that your chip card has already been read!
  • All requests are checked by us before they are handed over to you.

We treat your data strictly confidential.

Privacy Policy

    Your data:

    Your referral:

    Example: dermatologist (special field), check-up (cause)

    You agree that the data you provide will be used to process your request. For more information, see the Privacy Policy.

    The form fields marked with (*) are mandatory.

    Die mit einem (*) gekennzeichneten Formularfelder sind Pflichtfelder.