Enquiry form

Contact

University Hospital Basel
International Service
Spitalstrasse 22
CH-4031 Basel
Switzerland

Mondays – Fridays from 8am until 5pm

Enquiry form

Simone Rüdlin
Tel. +41 61 556 57 55
simone.ruedlin@anti-clutterusb.ch

Asel Epkenhans
Tel. +41 61 328 53 70
international@anti-clutterusb.ch

Elisabeth Schweinitzer
Tel.+41 61 328 53 70
international@anti-clutterusb.ch

Patienteninformationen

Title*

Patient’s surname*

Patient’s first name*

Gender

female

male

Patient’s date of birth *

Country of residence *

Telephone number (incl. country code) *

E-mail address*

Document upload

Do you need visa support?

yes

Preferred date of consultation

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