Future moms: Admission questionnaire

In order to facilitate administrative procedures, we thank you for filling in the questionnaire below to your official documents (ID card or Passport, certificate or family book, marriage certificate).

Informations personnelles
Father informations
Marriage, Children

(du mariage actuel)

lieu et date de la naissance précédente

Gynaecologist
I hereby confirm that the information I have provided is correct and that Swiss Medical Network can provide me with relevant information in the context of my request and thus accept the privacy policy.