Below is the request for scheduling a medical service, please fill in all the fields | | | | | | |
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Name and surname of the insured | | | |
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DZO card number of the insured | | | | | | |
Unique identification number(JMBG) of the insured | | | | | | |
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Detailed description of the problem | | | |
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The type of medical examination or service you want to schedule | | | |
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The place where you want to do the examination | | | | | | |
Municipality* (samo za Beograd) | | | | | | |
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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...) | | | | | | | | |
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Health institution 1 | | | |
Health institution 2 (in case the service cannot be scheduled in the institution 1) | | | |
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Contact phone | | | | | | |
Contact e-mail | | | | | | |
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Note: | | | |
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*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.
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