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For medical doctors

Registration for the pain therapy

This form is addressed to the attending primary care physician.

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.

The treating general practitioner can download this form, fill it in and return it to the Schmerzzentrum via

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

Printable form:

Form can be printed and returned in e-mail to

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