Kontakt

Tel. 089 547041-0

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Telefonische Erreichbarkeit
Mo - Do 7.00 - 12.00 Uhr
13.00 - 16.00 Uhr
Freitag 7.00 - 13.00 Uhr
Öffnungszeiten Praxisklinik
Montag 6.45 - 15.30 Uhr
Dienstag 6.45 - 15.30 Uhr
Mittwoch 6.45 - 16.00 Uhr
Donnerstag 6.45 - 15.30 Uhr
Freitag 6.45 - 13.00 Uhr
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Personal information »social freezing«

In order to prepare for your visit, we would appreciate it if you could provide some answers to the following questions.

The form will be treated confidentially and only used for the purposes of your treatment.
None of the data provided will be transferred to third parties!

Our questions for her

All questions marked with * are required fields.

Period / monthly cycle*
Former pregnancies?*
Do you have any allergies?*
Do you take medication?*
Have you had an operation in the past?*
Do you suffer from a serious illness?*
Do you smoke?*

General information

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Data protection notice

We would like to alert you to the fact that all data transmitted to us is stored and processed with the help of electronic data processing. The data entered in this form will be deleted after submission. We handle the information you provide with strict confidentiality and do not transfer it to any other party. Please consult our data protection notice.

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