Confidential international patient intake

Submit Your Medical Case Directly and Securely

Complete your case information and upload available records on this page. You do not need to open your email application.

Private file storageFormal Case IDMultilingual support

Secure case submission is now available. Medical records are not sent as ordinary email attachments. After submission, the case team is notified and will contact you through your preferred method.

Confidential medical intake

Submit your medical case securely

Complete the form and upload the records currently available. Your information is submitted directly to our secure case system—you do not need to send an email.

Medical files are stored privately and are not sent as ordinary email attachments. Our case team receives a secure notification after submission.

Patient information

Full name *Email *Phone / WhatsApp *Country or region *Preferred language *Preferred contact method *Time zone *

Medical information

Main diagnosis *Diagnosis dateDesired service *Current treatmentPrevious treatmentMain concern or questions *

Medical documents

Optional. Upload only documents relevant to this case.

Choose files or drag and dropPDF, JPG, PNG, DOCX or DICOM ZIP · Up to 25 MB each · 8 files maximum

Consent and confirmation

Required fields are marked with an asterisk.