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Allocation to:

Herr PD Dr. Büchel; Frau Prof. Dr. Gebhard, Herr Prof. Dr. Kaufmann; Herr PD Dr. Pazhenkottil, Herr Dr. Fuchs, Herr PD Dr. Gräni

Desired examination*
Clinical data*
Preliminary findings
Comments
Payer*

Appointment allocation*

Desired documentation

Please provide the exact name of the institute or clinic.

Please provide the telephone number of your attending physician or practice.

Please provide a valid e-mail address or fax number of your treating physician or practice.

Please provide a valid fax number or e-mail address.