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Request Medical Evaluation

Dear Patient,

You may submit your personal health situation for our attention, using this appropriate data collection form.

Please attach any results of analyses and exams already in your possession.

Our team will meet at no charge to evaluate your documentation, in order to understand if our center is effectively able to provide tangible assistance and if so, which professionals of our technical team, based on their specific skills, should be in charge of following you on your route.

Once this has been defined, our Information and Consultancy Manager will contact you to explain what our first meeting might consist of including all details, the duration of visits and costs.

If you then decide to schedule a first visit at our facility, our Reservations Manager can assist you to find the best available appointment in our agenda.


If you possess analysis or medical checks of your issues, please attach them here.
(max. 5 file, max. 3MB for a singel file)

The Center periodically sends insights on specific aspects related to health, practical advice directly suggested by its professionals and updates on the services provided.

You may withdraw your consent at any time.

In compliance with the art. 13 of the GDPR 679/2016 and our corporate Privacy Policy, we inform you that by submitting this form you authorize Biomedic to process personal data contained in the form itself in the manner and terms of the information provided.

I declare to have read and acknowledged the Privacy Policy (open in a new window).