For retail

Request for online medical service appointment

    Below is the request for scheduling a medical service, please fill in all the fields

    Name and surname of the insured

    DZO card number of the insured

    Unique identification number(JMBG) of the insured

    Detailed description of the problem

    The type of medical examination or service you want to schedule

    The place where you want to do the examination

    Municipality* (samo za Beograd)

    Date of desired appointment 1

    Time of desired appointment 1 (from...to...)

    Date of desired appointment 2 (in case 1. the desired date cannot be scheduled)

    Time of desired appointment 2 (from...to...)

    Health institution 1

    Health institution 2 (in case the service cannot be scheduled in the institution 1)

    Contact phone

    Contact e-mail

    Note:


    *In case we need additional information in order to schedule a health service, we will contact you by phone. You can expect a response within 24 hours on weekdays.

    *In the case of requests for scheduling diagnostics and additional or control examinations, it is necessary that you provide us with a doctor's report from the previous examination according to which the requested health services should be scheduled.