Registration for general consultation and chronic illness

We will get back to you as soon as possible. You can also use the form for questions to the clinic.

Fields marked are required so that we can reply.

First and last name

Date of birth

Street and house number

Postcode and town

Country (optional)

Telephone

Which applies to me I am not yet a patient of SGK I am already a patient of SGK Referral of a patient

For a referral, please enter the patient’s name above and name the referring person in your message.

For which consultation?

Whom would you like to see? We will follow your preference as far as the schedule allows.

Your enquiry

Preferred way to contact me Telephone Email Either

Files and reports Will be sent in a separate e-mail. I would like to wait until the consultation.

Your details go exclusively to Seegarten Klinik. For more information, see our Privacy Policy.