Patient Registration

Register

To create an account for your child, please first create an account for yourself. You will be able to create your child's account directly through your account.

Do You Have Insurance?* Yes No

First Name*

Family Name*

Email address*

Contact No*

Please enter phone number without space

Gender*

Enter Your Address*

Enter Your Postal Code*

Enter Your City*

Select Your Canton*

Country*

Date of Birth*

Password*

Hint : Password must contain 1 upper case letter , 1 lower cases letter , 1 special character and one number.

Confirm Password*

Insurance Number*

807560

Please upload insurance card image*

Please upload pasport or ID picture*

I accept all General conditions, Communication and privacy policy , Consent and Patient information on the processing of personal data

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