Sievering Clinic

Competence Centre for Minimally Invasive Medical Services

Patient Care

Medical history form

As a new patient, you have a lot of background to share with us. Use our Medical History Form when you are visiting for the first time.

Note: Print and fill this out to bring with you to the appointment to simplify the registration process.
To be sure to have the correct answers, please see with your doctor. Do not forget to bring the form to your first (next) appointment.

Important tip: Keep a copy for your records so that it is available when you need to visit other doctors.