Online appointment

Last name *

First name *

Date of birth *

E-Mail *

Telephone *

Best availability (time) *

Health Insurance *

Gynecologist

First day of last menstruation

Estimated day of delivery

Weight (kg)

Multiples: Number

Appointment *

Mornings

In the afternoon

Mornings or in the afternoon

Examination

First trimester screening (11 + to 13+ week)

High resolution organ screening (20+/21+ week)

Control examination

Chorionic villus sampling (11+/12+ week)

Amniocentesis (16+ week)

Additional informations

Consent

Yes, I agree that the professional practice Prof Dr Gunther Mielke and Dr Stephan Bosselmann, Doctors for Gynaecology and Obstetrics, Richard-Wagner-Straße 11, 70184 Stuttgart (Imprint, see footer) (also referred to as ‘Pränatalzentrum Stuttgart’) may use my voluntarily provided data to optimize appointment scheduling and to assess the urgency of my appointment request and prioritize it. You can withdraw your consent at any time with effect for the future. Further information on data protection and your rights as a data subject can be found in our privacy notice (see footer).

Freitext

* Obligatory information