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Make an appointment for an examination - Ambulance Neuropsychology Slezská

Please fill out the following form and make a binding appointment for the examination.


Fill in the actual details of the person interested in the service.

Date of birth
Month
Day
Year
Your insurance company
General Health Insurance Company - 111
Sectoral health insurance company - 207
Czech Industrial Health Insurance Company - 205
Škoda Employee Insurance Company - 209
District Brotherhood Fund – Health Insurance Company - 213
Health Insurance Company of the Ministry of the Interior - 211
I am a self-payer (or insured 201)
I come with a recommendation from: *
Crisis Center
Psychotherapist/ psychologist
Sexologist
Neurologist
At your own request/other
I am ordering for
Neuropsychological examination for adults (ONLY WITH A REQUEST FROM A DOCTOR, NEUROLOGIST)
I need help with
Mood disorder – depression
Anxieties
Attention deficit disorder
Memory disorders
Other, please fill in.

Contact

ambulance@intersepraha.cz

+420 731 904 995  

​data box: t7nj6tz

​Neuropsychology Outpatient Clinic
Slezská 1737/101
​raised ground floor

​Metro A Flora

Trams number: 16, 10, tram 11, 15,13

If you are driving, you can park in the blue zone (there is usually enough space)

​Documents for download

​Interse Internal Rules

​Information for parents
(FOR ADOLESCENTS in psychiatric care in JESENIOVÁ)

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