Pre-admission of patients

Telephone Exchange:

Queries:

For further inquiries regarding your application, please contact the Admissions Department at (+507) 305-6387 or 305-6300
Ext. 8022/ 8023/ 8010

Step 1 of 3

Personal information

Name and Surname(Required)

Gender *(Required)

Birthdate

ID or Passport

E-mail(Required)

Applicant's Address

Cell phone(Required)

Identity Document

Accepted file types: jpg, png, pdf, Max. file size: 50 MB.

Contact(Required)

Cell phone(Required)

Contact address(Required)

Doctor's name(Required)

Insurance company(Required)

Policy number(Required)