Portail patient

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Activation key request (only for patients without national registry number)

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Please complete the following form to obtain an activation key to create your profile.

Administrative data

Name

First name

Date of birth

Patient number Your patient file number can be found on one of your invoices received for treatment at Europe Hospitals

Legal sex

Male

Female

Other

Address

Address (Street and number)

Postal code

Locality

Country

Contact data

Email address

GSM number*

After analysis and validation of your request, an e-mail will be sent to you (within 15 days) containing an activation key valid for 72 hours to create your profile.

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