Family Doctor Registration

I am waiting for you to enroll on my patient list to access free (quality) medical assistance.

    Enrollment Form

    * If you wish to enroll multiple family members, enrollment is done separately for each member.

    Who wants to enroll?

    Have you been registered with another family doctor for less than 6 months?

    Has he been registered with another family doctor for less than 6 months?

    Name

    Surname

    Age

    CNP (Personal Numerical Code)

    Email address

    Phone number

    Identity Document

    Upload a photo with your ID card, passport, residence permit as applicable, or the child’s birth certificate (png, jpg, or pdf format).

    By submitting this form, you have read and agree to the privacy policy of this website, for the processing of personal data.

    What documents are needed for enrollment?

    You don’t need documents or agreement from your former family doctor!

    It’s very simple and fast. In short, all you need to do is complete the Enrollment Form displayed on this page. The only document you need is your identity document (ID card), and for children up to 14 years old, the birth certificate is required. After you complete the online form, your request will be verified and in the shortest time, you will be contacted to confirm and establish the next steps for final enrollment.

    Advantages of enrollment

    • Free in-office investigations
    • Continuous care for the whole family
    • Efficient disease management
    • Issuance of certificates and compensated prescriptions
    • Issuance and approval of medical leave

    Free Services

    List of medical services covered in primary care by the family doctor.

    Curative Medical Services
    Medico-surgical emergencies, acute conditions, chronic diseases, infectious diseases, etc.
    Curative Medical Services
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    Preventive Medical Services
    Informing and educating patients about a healthy lifestyle.
    Preventive Medical Services
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    Home Medical Services
    Consultations for non-ambulatory patients, by appointment only.
    Home Medical Services
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    Diagnostic and Therapeutic Services
    Functional investigations, therapeutic maneuvers, screening, and medical tests.
    Diagnostic and Therapeutic Services
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    Support Activities and Medical Documents
    Issuance of medical leave, compensated and free medical prescriptions.
    Support Activities and Medical Documents
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    Other Medical Services
    Administration of vaccinations included in the national immunization program.
    Other Medical Services
    Learn more