Registration to a family physician's patient list

APPLICATION FOR REGISTERING IN THE LIST OF A FAMILY PHYSICIAN

The application for registering in the list of a family physician must be completed and
digitally signed using the form below.

A separate application must be completed for each family member.
A parent or guardian must complete the application for a minor. Newborns are automatically registered with the family physician of the mother as an exception. However, a separate application must be completed if the newborn
needs to be registered with a different family physician.

Thank you for your trust!

Choose the family physician whose list you would like to register with

Your first and last name

Personal identification code

Street/Farm

Village/borough

Parish/City

County

House

Apartment

Index

Country

Phone number

E-mail address

Patient list
Please add me to the registered list

My previous family physician was

Of the family members closely related or related to me, the following persons are on the list of this family physician:

Note if you are choosing a family physician who has a list of more than 2000 patients

Name

Personal identification code

Temporary or permanent address

How you’re related

I am choosing the list
For the first timeI am exchanging family physicians

Date

I have read and agree to the Privacy Policy and Terms of Use of Perekliinik OÜ
I have read and agree to the Rules of Procedure of Perekliinik OÜ

Digital signing is required to complete the application.
Please add a digital signature to your filled application by clicking the button "Add digital signature" and by following the instructions.

We will inform you about the acceptance or refusal of inclusion in the general practitioner’s list within seven working days from the submission of the application. If you do not receive a response within this time, please contact us at nimistud@perekliinik.ee.

We may refuse if our general practitioner’s list is already full or if the person’s place of residence is not within our service area. In cases where the list is full, we usually include individuals in the list only if a family member is already on the list and they live within our service area.

Perekliinik does not register individuals in the family doctor’s list who are in temporary protection status in Estonia. For medical assistance, anyone can always contact us.

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