I have read the information about the rules and prices for the second-opinion services as well as the Terms and Conditions of SilaMed and accept them. I have read the Privacy Policy of SilaMed and agree to the following Collection of Personal Data Policy.These declarations of consent are given voluntarily and I may withdraw them at any time. The legality of the data processing shall remain unaffected unless it is withdrawn. 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 info@silamed.de 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 info@silamed.de. 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, Austrian or Swiss medical provider – that is a decision that remains entirely up to you. 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 at the end of the this Preliminary inquiry / application form).