Instructions
Appointment requests must be made at least 72 hours prior to the desired date.
After completing the required information, you will be contacted by phone to confirm the appointment.
If you are not contacted within 2 working days from the form submission date, the appointment for the requested date/specialty/service cannot be confirmed.
Failure to attend the scheduled time after appointment confirmation will result in the cancellation of the opportunity to make a new appointment.
PLEASE NOTE THAT ONLY IN SPECIALTIES MARKED WITH AN ASTERISK (*) CAN FREE CONSULTATIONS BE PROVIDED BASED ON REFERRAL TICKETS ISSUED BY THE FAMILY DOCTOR/SPECIALIST UNDER CONTRACT WITH CASMB. SOME MEDICAL SERVICES/CONSULTATIONS MAY BE SUBJECT TO FEES.
Specialty: —Please choose an option—ALLERGOLOGY*CARDIOVASCULAR SURGERY*GENERAL SURGERY*PLASTIC SURGERY*THORACIC SURGERYDERMATOLOGY*DIABETES AND NUTRITION DISEASES*ENDOCRINOLOGY*HEMATOLOGY*INTERNAL MEDICINE*NEPHROLOGY*NEONATOLOGY*NEUROSURGERY*NEUROLOGY*PEDIATRIC NEUROLOGY*OBSTETRICS GYNECOLOGY*OPHTHALMOLOGY*EAR, NOSE AND THROAT*ORTHOPEDICS AND TRAUMATOLOGY*PSYCHIATRY*PEDIATRIC PSYCHIATRY*PSYCHOLOGYUROLOGY*
Medical service: —Please choose an option—Consultation with referral tickets from CASMBPaid consultation
Medical service: —Please choose an option—Paid consultation
Medical service: —Please choose an option—Consultation with referral tickets from CASMB
Date:
Full name:
Phone:
Email:
Additional information:
On the day of the appointment you must present yourself in person the following documents:
- IDENTITY CARD
- REFERRAL TICKET
- HEALTH INSURANCE CARD
- PENSION COUPON (IF APPLICABLE)