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For medical doctors

Registration for the pain therapy

This form is addressed to the attending primary care physician.

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With this pain therapy form, primary care physicians register their patients at the Pain Center Schmerzzentrum am Kunstmuseum Basel for the desired treatment and issue a referral.

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The treating general practitioner can download this form, fill it in and return it to the Schmerzzentrum via schmerzzentrum.kunstmuseum@hin.ch.

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The Pain Center Schmerzzentrum am Kunstmuseum Basel bills via the basic insurance, the so-called TARMED.

Fillable form:

Form can be edited on the desktop/computer and returned to schmerzzentrum.kunstmuseum@hin.ch

Printable form:

Form can be printed and returned in e-mail to schmerzzentrum.kunstmuseum@hin.ch

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