Radiology voucher

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Download and fill out our radiology voucher
Transfer your completed and signed voucher *
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Accepted file types: jpg, jpeg, pdf, Max. file size: 300 MB, Max. files: 3.
You can send us a photo of your radiology voucher or scan it and drag it below.
Remarks
Coordonnées du patient
Nom du patient*
N° de téléphone (mobile)*
Email du patient (pour copie de bon)
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.

Coordonnées du patient