Online birth registration

Birth registration

Fields marked with a red dot   are mandatory!


Title Mrs
Last name   
First name   
Academic degree
Street
Number / Flat Nr.
City
ZIP Code
Country
Telephone number   
E-Mail

Attending
physician
  
Expected
delivery date
  

Please send me your info brochure via mail**

Please send me your info brochure as a .pdf file via e-mail*

      If you have priority category insurance, we will settle any costs directly with your
      insurance provider according to your contract. We do not provide any special price
      lists for this case. Please consult your insurance agent for any questions concerning
      deductibles or the co-insurance of babies.


     I do not have priority category insurance and would like to receive
     the following price list:
*
I am compulsorily insured in Austria with the GKK / SVA / KFA
I am compulsorily insured in Austria with the BVA
I am compulsorily insured in Austria with the VAE
Direct payer (no compulsory Austrian insurance)

Requested call-back by midwife

Requested call-back by clearing centre staff

No registration required, I only want to receive the selected information material

Other comments:

*)If you have requested any information materials, all address fields (street, number, ZIP code, city, country) and your e-mail address are compulsory fields as well.

Any questions or remarks?
Do not hesitate to call us MON – FRI between 13.00 and 17.00 at +43-1-40 111-3100

Kind regards,
Your midwifes of the Goldenes Kreuz private clinic

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Please enter the result of the following calculation as a DIGIT (e.g. one + five = 6):

six + four =



Online birth registration
 
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