Der Zweck dieses Fragebogens ist es, einen Überblick über Ihren Gesundheitszustand zu erhalten und dem Arzt Informationen darüber zu geben. Bitte bringen Sie Ihren Impfpass, ärztliche Berichte oder aussagekräftige Untersuchungsergebnisse mit.
Alle beiliegenden Informationen unterliegen der ärztlichen Schweigepflicht.
Bitte senden Sie diesen Fragebogen vollständig ausgefüllt (im PDF-Format) an die folgende E-Mail-Adresse: med.prev@hopitauxschuman.lu
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