Please contact us and send your medical enquiry

Please contact us by completing the inquiry form below.

The more medical details we receive, the better our response will be.

All patient requests are subject to confidentiality, of course.

fon: +49-761-79117-228

When we receive your message, you will be assigned your personal case manager.

As well as managing all the details of your medical enquiry and treatment, your case manager will also be available to support your travel organization, visa process and logistics.

Your enquiry will be answered within one working day.

Thank you very much for your interest in the Gelenk Clinic.

Gender *

First Name, Family Name *

Your Birthday *

Month

Day

Year

Please enter your birth date

E-mail Address *

Phone Number *

We will call our international clients back within 24 h during working days in order to confirm and verify your inquiry.

Street Address, Number *

Postcode, City *

Country of Residence *

Please enter your country of residence

Do you need assistance with Visa-Application? *

Submit medical details to our specialists

In this section we ask some general questions about your illness. These answers will help our experts to understand your inquiry better. After submitting this form you will be redirectd to an upload form for files and medical images. You may leave this section empty and proceed to the "Submit" button below.

Since when do you have your condition?

Please describe the beginning of you condition. How many weeks, months or years do you suffer already?

Please submit your orthopaedic diagnosis, if possible

Please give us the clinical term(s) of your medical conditions

What caused your condition?

Is your condition work related, sports related, accident related, or age related?

Are you in pain? What situation triggers the pain?

Please describe your pain. Did the pain become worse quickly? Is it worse when you are walking? Do you feel pain while resting? Do you need pain medication? What gives you relieve (e.g. bending forward, sitting, lying down)

Do you feel a loss of sensitivity, paralysis, loss of strength or tingling?

Particularly back pain do you feel numbness, loss of sensitivity, paralysis, Loss of motoric coordination, loss of strength or tingling in neck, back, arms, hands, legs, ankle or feet?

How is your health? Do you have underlying conditions?

Here you can tell us about your health. Do you have underlying conditions such as osteoporosis, diabetes, obesity, high blood pressure, neurological conditions? Do you practise a particular sport? Do you have specific work related strains? Did you suffer a trauma in the past, such as an accident?

Upload a file

Click here to visit our file transfer service

Legal Disclaimer

Personal data provided will not be disclosed to third parties. Your information will be stored and used only for the fulfillment of the stated purpose of contact and in order to respond to your enquiry. Your data is subject to medical confidentiality. The transmission of data to the medical staff is via e-mail. This is subject to normal e-mail distribution risks and the risk of data corruption. The identity of the sender can not be verified by us. Communication via this form is therefore not legally binding for either party. This service is provided by us in order to facilitate and prepare for medical investigation and medical treatment. The service does not constitute or replace a face to face medical check up, or treatment by a qualified physician. Any electronic communication by us resulting from this data, is to be treated as general information. In order to act upon this information, please consult your local physician, until such a time that you have been examined by the medical team at the Gelenk Klinik.

Confidentiality agreement *

I agree with the legal Disclaimer and the Confidentiality agreement

I do not agree with the legal disclaimer and the Confidentiality agreement

Your Message to the Clinic: How can we help you? *

Please give us more information about how we can help you. Would you like diagnostic support? Would you like to book a surgical appointment?

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