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Interview sheet


Questionnaire download

We will ask you to fill out a medical questionnaire on your first visit.
If you print it out from your home computer and bring it with you, you can shorten the waiting time at the reception on the day. If you are interested, please use the form below.

ophthalmology questionnaire

Medical Questionnaire (Ophthalmology)

Cosmetic Dermatology Questionnaire

Urology Questionnaire

Influenza vaccination pre-examination form (under 65 years old)

* If you are 65 years old or older, we will give you a special pre-examination slip at the reception of our hospital.

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