New patient registration

Inscription
nouveau patient

Dr Nicolas Peyraud

Please fill-in the form below. You will then be able to immediately make an appointment as an “existing patient” via the calendar.
Your information will be treated securely and confidentially.

We need accurate information in order to create your child’s medical record. Please check the accuracy of the information you have provided before confirming this registration. Incorrectly entering your child’s insurance number (always starting with “807…”), your email address or your telephone number will automatically result in the cancellation of the appointment you have made.

You can also contact us by phone at 079 768 45 97 between 10:00 and 10:30 AM and between 7:30 and 8:00 PM if you need additional information. If we are busy seeing patients, please leave a message on the answering machine and we will call you back as soon as possible.

Due to logistical constraints, we only see children who live in a building with an elevator or who live on the first floor.

If you are unable to attend, please inform us at least 24 hours in advance (by cancelling the appointment yourself on the OneDoc platform) so that we do not have to charge you for the time reserved for the consultation.

Patient (child) information

Family name

First name

Date of birth

Health insurance name

Health insurance card number

Previous primary care physician following your child up now

Child’s legal guardian

Family name

First name

Email address

Adresse

Zip code/City

Building entry code

Floor (if in an apartment building)

Phone number (mobile)

Message / Comment

COVID-19

For all patient encounters, we follow the COVID-19 precautions and public health measures required for health professionals by the Federal Office of Public Health (FOPH).