Medical history questionnaires

We offer you free of charge a fast and efficient diagnosis as well as a consultation based on our

 

Medical history questionnaire: cervical spine

 

or

 

Medical history questionnaire: lumbar spine.

 

 

 

Please fill in the appropriate questionnaire and attach the written statement (scanned) of your MRT photographs.

 

You also can send it to us

via fax 0228 - 386 30 69

or via letter.

 

The questionnaire tells us a lot about your spinal maladies and therefore is very important for the diagnosis. In addition, together with your MRT and x-ray reports, we also can assign the right doctor to you already before your visit to the Zentrum für Orthopädie.

 

In the case the original photographs are needed for the diagnosis, you can send them to us via letter or email.