Forms

Request second opinion

Please fill out this form below and send me an email (Email) or fax (+49 551 39 89 81). The office numbers to schedule an appointment are +49 511 39 8787 or +49 511 39 65101 (secretary).

Request form and checklist "Second opinion"

Pain diagram

Please use the following pain diagram to indicate painful areas.

Pain diagram

Visual analog scale (VAS)

The visual analogue scale (VAS) is a measurement instrument for pain and other subjective characteristics that cannot be directly measured. The Score can be filled out out online. You can print the results and use it for your appointment.

VAS - Visual analog scale