Appointments request and other requests

The content of this message can be read and processed by our secretariat.
We process your requests as quickly as possible but do not guarantee any response time. For urgent requests, contact your center or the emergency services by telephone.

Identity*
Civil status First Name Surname
Email address*
Mobile phone number*
(e.g.: 076 123 45 67 or 0033 6 12 34 56 78)
Concerned centre*
Your request / appointment booking*
Conditions*
- I confirm that I have read the terms of the electronic communication and privacy policy and agree to receive medical information by e-mail which may be unencrypted.
  
  I understand that I can withdraw my consent at any time to receive medical information by contacting my healthcare provider or via info@magellan.ch.
Name
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