Second Opinion

When you or a loved one is diagnosed with cancer, it is normal to wonder if another specialist can offer another treatment option or more information about your condition, many questions and concerns arise and choosing a treatment plan can be overwhelming.

A second opinion can give you more information about the condition, learn about other treatment options, feel more confident in your diagnosis, and make a decision about the most appropriate treatment.

Patient information

Name*

Surname*

Email*

Patient’s date of birth*

Patient's age*

Gender of the patient

WomanMan

Is the patient a minor? *

Not a minorYes, it is a minor

Name and surname of the patient's father, mother or guardian

Patient email (optional)

Patient mobile number * (optional)

Does the patient require an interpreter? *

NoYes, it requires an interpreter

If you require an interpreter, what language is required?

State where the patient lives*

City or Municipality where the patient lives*

Area where the patient lives*

Zip code where the patient lives*

Country where the patient lives *

Write the address where the patient lives *

Information for patient’s appointment

Indications or diagnosis

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Second Opinion

Second oncology opinion