International Treatment Inquiry

Should you wish a medical examination or treatment, please provide us with this form completed in English and the necessary medical Report.

» Form in German / Formular in deutscher Sprache

Kontakt englisch (neu) / Selbstzahler

Patient data

Providing the information requested in the following two fields (Passport number and copy of the passport) is voluntary. However, as treatment can not be carried out at Klinikum Stuttgart without the data asked for in those two fields, we have marked them as mandatory. Reason is, that this information enables accurate identification and thus serves patient safety.

Contact data of requestor
Medical Information
Medical Reports
Total size of documents may not exceed 50 MB.
Bitte Rechenaufgabe lösen und das Ergebnis in das Feld eintragen.
You have problems to submit this form? Please check previous steps for missing mandatory information.