Registration with a general practitioner

Sign up form

Please fill in the form below. Fields marked with * are required.

Your personal information

Degree:
First name: *
Last name: *
Degree after name:
Gender: *
Insurance number: *
Telephone: *
E-mail: *
Nationality: *

Address

Residential address: *
City: *
ZIP code: *

Temporary address:
City:
ZIP code:

Others

Current general practitioner:
Current general practitioner’s address:
Insurance company: *
Note:

Select a registration type:

Selected Select

True care Basic

(formerly Registered patient)

Become a registered patient of the True Doctor and get all the benefits available upon registration.

Multidisciplinary care within one clinic
Booking for the exact time
Professional consultation with the doctor (phone/email)
Ambulatory examination if indicated by the health insurance
Discounts for services not covered by health insurance:
- Discount on occupational health services
- Discount on ellaboration of medical fitness reports
- Discount on vaccination
- Discount on infusion therapy
Premium clinic in Prague center

2500 Kč / year*

Selected Select

True care Premium

(formerly True care)

Treat yourself to the best services offered by a GP and enjoy the TRUE CARE.

Multidisciplinary care within one clinic
Booking for the exact time
Professional consultation with the doctor (phone/email)
Ambulatory examination
Discounts for services not covered by health insurance:
Occupational health services once a year for FREE -
Ellaboration of medical fitness reports -
Discount on vaccination -
Discount on infusion therapy -
Once a year for FREE preiperation examination for surhical procedured not covered by the health insurance
Premium clinic in Prague center
Regular notification of all preventive and recommended examinations
Once a year entitlement to a comprehensive examination by an internist
Overall organisation and planning of healthcare

Monthly payment
(1400 Kč / month*) Annual payment
(14990 Kč / year*)

*By paying the amount for the first month you apply for the monthly subscription.
The stated prices are valid only under the conditions of concluding a contractual relationship for at least 1 year.

I consent to my personal data processing. * I agree with the general terms and conditions and internal rules of Ambulance Penta s.r.o. * I agree that Ambulance Penta s.r.o., which operate the True Doctor’s medical office and the True Dentist’s clinic will send me information, newsletters and other business communication. This will include information on medical care, services, offer of recommended prevention programmes and other commercial offers of the aforementioned companies. I may cancel receiving the information at any time. I wish to become the True Doctor’s registered patient. *