Contact form Women's Clinic

You are welcome to send us an appointment request online. We will get back to you within the next few days.
If it is an emergency appointment (within the next 24 hours), please contact us by telephone on 041 399 32 10.

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Please select the desired consultation hour

Concerns/Complaints

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Attending physician at Zug Cantonal Hospital

General practitioner or gynaecologist

Insurance information

Competent health insurance company/insurance*

insurance number

insurance class*

General

Semi-private

Private

Patient data

Salutation*

Date of birth*

Last name*

First name*

Street/no.*

Postcode*

City*

Phone / Mobile*

E-Mail*

General

Do you agree that the Zug Cantonal Hospital may obtain the medical information necessary to carry out the treatment from the doctors and medical personnel providing the treatment and release the persons named from the professional confidentiality obligation to this extent?

Obtain medical information*

Yes, I agree that the Zug Cantonal Hospital may obtain the medical information necessary to carry out the treatment from the doctors and medical staff providing the treatment and release them from their professional confidentiality obligations.

No, I do not agree that the Zug Cantonal Hospital may obtain the medical information necessary to carry out the treatment from the doctors and medical staff providing the preliminary treatment.

Data privacy*

I confirm that I have read the information on data privacy and accept it.

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