Allianz Registration

Allianz Insured Patient’s Registration.

Please fill the appropriate Form if you want us to do Direct Billing with your Allianz Insurance Company.
The Hungarian National Insurance – TAJ Card – is not accepted as payment.
We may use the TAJ Card number for registration only.

Allianz World Wide Care Insured Patients Initial Registration.

Patient Data and Medical History Collection Form

Patient Data Additional Information or Clarification

Additional or Supplemental Information Option.