Create an Online account

Create your online account in three simple steps:

Your provide us your personal details
We send you an email with a link inside
You click the link to log in to your account

Salutation

Surname

Please use the exact same as on your insurance card.

Name

Please use the exact same as on your insurance card.

Date of Birth

For example: 24.12.1969

E-Mail

We use this to send you an email confirmation of your request and to notify you when your prescription is ready.

Phone (optional)

We can use this to notify you when your prescription is ready.

I consent to providing my personal data in order to process my request.I’m happy for the clinic to contact me about relevant treatments and/or services.

Create an Online account

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