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Medical Forms

Please provide us with your personal information. This will be treated with total confidentiality.

In order to undergo our treatment, we first ask you to complete our the medical form below. This will be reviewed by Dr. Waismann before we contact you to arrange your travel and accomodation.

Your stay will be one week. When you land, you will be picked up at the airport by our staff and transported to the Dr.Waismann ANR Clinic for a first consultation, evaluation and medication that will allow you a comfortable pre-hospitalisation stage.

After the hospitalisation period, you will stay in a modern, first-class hotel which offers all the facilities you need to recover in the best conditions. Dr.Waismann will visit the patient during this recuperation phase.

After your week is over, you will be transferred to the airport to fly home and start afresh.

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We respect your privacy and treat all inquiries as strictly confidential.

Email Information

If you choose to correspond further with us through email, we may retain the content of your email messages together with your email address and our responses.

We provide the same strict protections for these electronic communications that we employ in the maintenance of information received by mail and telephone.

Confidentially is of the utmost importance to our clinic and visitors to its Websites. We do NOT provide information about our Web site traffic patterns and related Web site information to third parties, including personally identifying data.

Feel free to call us if you have questions: 212-267-7283 CONTACT US