Quick application

About 3–5 minutes Secure and encrypted

Application / Case No Generating secure reference… This number is created automatically and will stay attached to this application.

Preliminary review fee Loading the current preliminary review fee…

Current TRY equivalent: Updating…Current USD equivalent: Updating…

Fill in the essentials, upload the documents you already have and pay on the next screen. If our medical team needs anything else, we will ask you after payment through your patient portal.

1Who is this application for?

For myselfI am applying as the patient.For a relativeI am applying for a family member or someone I care for.

2Contact details

We send every update to this person by WhatsApp and e-mail.

Applicant full name *

Applicant email address *

Applicant phone number *

Applicant country of residence *

3Diagnosis

Diagnosis Category * Select the main medical area first.

Diagnosis Type * Only diagnosis types related to the selected category will be shown.

4Medical documents

Upload every medical document you have in one go: discharge summary, pathology, laboratory and blood tests, MRI / CT / PET reports, genetic tests, doctor reports and prescriptions.

Drop your files hereorChoose filesPDF, JPG or PNG · several files at once

5Passport or IDOptional

You can upload it now or add it later from your patient portal.

Upload passport / ID

No file selected

6Consent

Refund rule: if you withdraw after paying but before your file is sent to the doctor, your fee is refunded. Once your file has been sent to the doctor, the fee is not refunded, whatever the doctor's opinion. If the doctor asks for more documents, you do not pay an additional preliminary review fee.

✓I confirm the information is accurate and I agree that my medical documents are processed for evaluation and shared with the relevant specialists. ✓I have read and accept the Terms of Use, the Privacy Policy, the Medical Data Consent and the refund rule above. ✓I would like to receive short WhatsApp reminders about updates on my case. No medical details are ever sent by WhatsApp. (Optional)

What happens after payment?

Your application number is confirmed, and your payment confirmation and patient portal sign-in details are sent by e-mail.
Our medical team checks your documents one by one and lets you know if a page is unreadable or missing.
If any information or document is missing, we complete it together with you through your patient portal.
Your documents are translated into Spanish and passed to the specialist in Cuba.
The target for the specialist opinion is about 4 business days after your file reaches the doctor.
We explain the doctor's opinion to you in plain English, and keep you informed by WhatsApp and e-mail at every step.

Prefer the detailed form? Open the full application