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International Medical Services Department

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Second Opinion Request Form

Please note, only numbers and a "+" are allowed in this field. Telephone number must begin with a "+" or a "0". E.g.: a telephone number in Russia should be indicated as follows: +71234567890 or 0071234567890

Upload your medical reports (no image files)

You can also upload your radiological images directly into our hospital’s system. We will send you the correspondent link upon request. Additional medical reports can also be send at: telemedicine-ims@uniklinik-freiburg.de
Do you want to disclose information and/or authorize somebody to enquire about your medical treatment (family members, friend, doctor or other third party?)
Rules and prices*
Privacy policy*
These declarations of consent are given voluntarily and I may withdraw them at any time. The legality of the data processing shall remain unaffected unless it is withdrawn.
Please note: according to the German law, your physician must be present during your online-consultation

1All the terms are subject to the law of the Federal Republic of Germany. Exclusive place of jurisdiction shall be Freiburg in Breisgau, Federal Republic of Germany.

*required field