Diagnostic request - polysomnography

St-Elisabeth site - Uccle

St-Michel site - Etterbeek

Bella Vita Medical Center - Waterloo

External consultation Inkendaal

Last name

First name

Are you already a patient at the Europe Hospitals??

Yes

Date of birth (dd/mm/yyyy)

Address

E-mail address

Telephone number

Requestor

Reason for examination

Doctor to discuss results

Dr SMETCOREN Charlotte

Dr ROUGUI Ihsan

No preference

Please note that polysomnography is only reimbursed once a year. Please ensure that your last diagnosis was made more than a year ago.

Useful links