Appointment form

We do not promise to cure you, but we will do everything we can to make it happen.

Thank you for your confidence and for choosing our GE office. Patients who are duly insured in the Slovak Republic and meet the appropriate legal requirements (i.e. bring an recommendation ticket from Slovak GP or another specialist, or in case of emergency come without it) do not pay for the examination. Payments only apply to self-requested procedures or to uninsured patients. In particular, please check your contact information carefully or we may not be able to respond to you. If you have received a copy at the email you provided on the form, your order has been received correctly. If you do not receive a reply within 24 h. please contact us by email or via WhatsApp or Messenger, click on the page below. Please make sure you don't have our mail in your spam folder beforehand. However, if you have receive a reply with the proposed dates and do not respond within 24 h., your order will be automatically cancelled. Please make sure you do not have our mail in your spam folder beforehand. Don't forget your recommendation ticket from your Slovak GP or another specialist (výmenný lístok).Urgent cases we admit just during working hours. Thank you! Data sent via this site is protected by a Let's Encrypt security certificate.

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Reason for your appointment *

Title

Your name or nickname *

Age *

Email *

Mobile phone number (SK) *

Have you had an appointment with us before?*

yes

no

Have you had a GE appointment in SK before? If yes, when?

Do you need an immediate appointment? (10€ for not having to wait)*

yes

no

Please, choose the three most convenient dates for your appointment *

Please describe your GE complaints *

0 (Max. 800 Characters)

Please, list any prior examinations you have had concerning your complaints or send it in attachment below *

0 (Max. 300 Characters)

Please, list any treatment (medication and procedures) you have had *

0 (Max. 200 Characters)

Please, list any other diseases/complaints you have *

0 (Max. 300 Characters)

Only those interested in paid services can upload attachments below. We recommend that you send them without personal data or protected by a password, which you send as an SMS to 0940 890823. Attachment (max. 10 MB, if you are not sending anything, leave the field empty).
The following formats are allowed: rar, zip, doc, docx, xls, txt, gif, jpg, pdf, tif, png, bmp

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Contacts

GASTROENTEROLÓG s.r.o.
J. Kráľa 3
940 01 Nové Zámky

+421 35 6423 285
+421 940 890 823
klucho@gastroenterolog.com

IČO: 45 723 966
DIČ: 202 311 45 11

GPS coordinates of the object

latitude
47.9829 N
47°58'58.44" N

longitude
18.1579 E
18°9'28.44" E

Appointment form

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