Medizinisches Zentrum Seegarten (Swiss Site) Medaesthetics (Swiss Site) Print Page
HOME REGISTRATION OUR SERVICES  
e-Registration
Contact us
To be prepared
Health questionaire
REGISTRATION FORM

This form is not to be used to obtain an appointement if you are already registered with us.

Please contact me to make an appointment.
I will contact the clinic to make an appointment.
We have already agreed on an appointment.
Registration for
Dr. med. John van Limburg Stirum
Dr. med. Sch. Khoschnewis
Dr. med. Ingrid B. Riedel
Dr. med. Ph.D. Alois Fister
Dr. med. Corinne Schlösser
Dr. med. dent. Florian Krass
Last Name
First Name
Title
Date of birth
Address
Area Code / City
Profession
Employer
E-Mail
Tel. Private
Tel. Office
Tel. Cell
Your Homepage
How die you
hear about us?

If you are a foreigner without an insurance in Switzerland the complete treatment will be charged on a private basis.

For all those living in Switzerland and possess Swiss health care, according to the current Swiss law, some of the tests and examinations, as well as therapies performed at the clinic are not covered by the general health insurance. This is also true for some of the medications. Therefore at the end of your treatment, you will get two bills, one reimbursable by the basic health insurance and one covering the complimentary medicine benefits, which is sometimes reimbursed by certain insurances, in other cases has to be paid by the client. In the Swiss law of health (KVG) there are time limitations for the reimbursement of certain positions. Please ask if you have any questions. As time consuming evaluations and discussions with doctors are necessary for a responsible and effective treatment, we sometimes recur to positions of psychotherapeutic talk.

In case of absence or non-appearance without notice (within 24 hours before appointment) we will have to charge you some of the time lost.

  • I have read and accepted the above mentioned modalities.
  • It is my wish to be treated with the approach of integrative medicine.
  • I case of debt enforcement I allow the necessary data to be forwarded to the responsible institutions.
I accept this agreement.
At the moment I do not want to accept this agreement because I have further questions that I would like to address at the first consultation.

LAKE GARDEN MEDICAL CENTER
Seestrasse 155A, CH-8802 Kilchberg
Tel.: +41-(0)44 716 48 48 Fax: +41-(0)44 716 48 47
www.lakegardenclinic.ch, E-Mail: office@lakegardenclinic.ch