SilaMed - diagnostics and treatment in Germany
            SilaMed -  diagnostics and treatment in Germany

Preliminary inquiry / application form

Your preliminary inqury is going to be processed and confirmed within 24 hours.

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Preliminary Inquiry / Application Form:

Bitte korrigieren Sie Ihre Eingaben in den folgenden Feldern:
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Hinweis: Felder, die mit * bezeichnet sind, sind Pflichtfelder.

* Please note: the fields indicated with * are mandatory fields. At the end of the form please enter the letters of the spam-protection-code indicated in the field Captcha.
In order to send the form please press the button Formular senden
(this button is under the field Captcha).


You can also send us copies of your medical documentation confirming your diagnosis. In order to protect your personal data during the transmission of the documents we kindly ask you to send us copies of the medical documentation separately by e-mail to our e-mail address indicating in the e-mail to which request these documents relate (date of the submission of the form/inquiry and the name of the sender). Please send us the attachments in the following formats: .pdf or .tif.

You can also send us a preliminary inquiry with the supporting medical documentation directly by e-mail to our e-mail address Your preliminary inquiry is going to be processed and confirmed within 24 hours.

Please note that SilaMed cannot provide any medical advice, diagnosis or treatment, and does not make recommendations in choosing a German medical provider – that is a decision that remains entirely up to you.

Tel +49 6174 249588


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