Online appointment form - Medical imagery

Once you have completed and validated the form below, we will send you your appointment date by email, text message or post within 48 hours. Don't hesitate to call us for further information.

Please note: any appointment cancelled less than 24 hours before the scheduled date will incur an administrative charge of 25 euros. For MRI appointments, this fee will be €100.

Don't forget to include a telephone number (landline or mobile) where you can be reached during the week, so that we can contact you during office hours.

Site

One file only.
15 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

Type of examination

Genre

Your details

Name
First name

New patient? Give us your address:

I agree to take my exam at HUDERF if the deadlines are shorter.
HUDERF is located avenue Jean Joseph Crocq 15 in 1020 Brussels (Laeken)
I agree to take my exam at Bordet if the deadlines are shorter.
The Jules Bordet Institute is on the same site as the Erasmus Hospital in Anderlecht.