Rudolfinerhaus - Vienna's Leading Private Hospital

Terminanfrage Tagesklinik EN

Mr/Ms

Acad.

First name

Last name

E-Mail

Date of birth

Street/no./door no.

Postal code

City

Request for appointment

Gastroscopy

Colonoscopy

Gastroscopy & Colonoscopy

Other

Preferred dates (please indicate more than one):

Cancellation Policy

I acknowledge that I will be charged for the entire cost of the service if I fail to attend an appointment and do not cancel at least 24 hours in advance.*

I agree to the automated processing of my contact details including email address by RUDOLFINERHAUS Privatklinik GmbH.*

Registration RUDOLFINERHAUS Premium - Stay well informed with our newsletter! With your consent, you agree to the automated processing of your contact details, including your email address, by RUDOLFINERHAUS Privatklinik GmbH and the sending of information and advertising materials (§ 107 TKG). Consent can be revoked at any time by sending an e-mail to datenschutz@rudolfinerhaus.at.

Terminanfrage Privatambulanz EN

Mr/Ms

Acad.

First name

Last name

Date of birth

Phone

E-Mail

Street/no./door no.

Postal code

City

Request for appointment with a specialist or desired examination including preferred date(s):

Additional request(s)

How should we contact you?

I would like to recieve a call

I would like to recieve an email

Checkbox Field

I acknowledge that I will be charged for the entire cost of the service if I fail to attend an appointment and do not cancel at least 24 hours in advance.*

I agree to the automated processing of my contact details including email address by RUDOLFINERHAUS Privatklinik GmbH.*

Registration RUDOLFINERHAUS Premium - Stay well informed with our newsletter! With your consent, you agree to the automated processing of your contact details, including your email address, by RUDOLFINERHAUS Privatklinik GmbH and the sending of information and advertising materials (§ 107 TKG). Consent can be revoked at any time by sending an e-mail to datenschutz@rudolfinerhaus.at.

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