ZSEKontakt (engl.) | Uniklinik Ulm

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Contact form for doctors

Your contact details

Practice/hospital/department or ward *

Salutation

Mister

Woman

Title

Contact person *

Your email *

Your callback number

When and what time is the best time to reach you?

How can we help you?

Specific question to the center *

Would you like an assessment of the file situation?

Yes

No

If yes, name of the diagnosis(s), if known:

Main symptoms if diagnosis unknown:

How else can we help you?

Telefonic consultancy

Expert search for a specific SE

Other issues

When selecting "Other questions":

Patient data: age

Your question to the center

Important note: Please only anonymous information

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Consent *

89070 Ulm

Telefon: 0731/500-0

Telefax: 0731/500-43002