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SDK - Request of doctors visit
Patient Name
*
First
Last
Swedish Social security number (if applicable)
DOB (date of birth)
*
Patient Phone
Address (Temporary in Sweden)
*
Address Line 1
City
State / Province / Region
Reason of doctorsvisit
*
Type of visit
*
At one of our clinics (SEK 1500)
Doctor comes to the patient (SEK 5000)
Time of appointment
*
ASAP
Next day
Contact SDK email about appointment
File Upload (if needed)
Contact person - SDK
SDK Contact Person
*
First
Last
Email
*
Email
Submit
