Online appointment form

Child's contact details
Parents are
Agreement of both parents
Mother's contact details
Father's contact details
Is your child already being treated at HUDERF?
The child attends a school
Have you ever had a consultation with a child psychiatrist - neuropaediatrician - psychologist - neuropsychologist - speech therapist?

Maximum 3 files.
5 MB limit.
Allowed types: jpg, jpeg, png, psd, txt, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, gz, jar, rar, tar, zip.