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Gain access to treatment in foreign clinics through the Medevac program. Your health is our shared goal!
*By applying to Medevac Ukraine, you consent to the processing of personal data
Your region of residence
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Chernivtsi Region
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Where are you currently located?
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Gain access to treatment in foreign clinics through the Medevac program. Your health is our shared goal!
*By applying to Medevac Ukraine, you consent to the processing of personal data
Please provide your full name without abbreviations
Please provide your date of birth
Clinical diagnosis
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Healthcare facility
Вкажіть ваше ПІБ повністю, без скорочень
Please provide your date of birth
Clinical diagnosis
Upload a photo or scan of the medical record extract
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Apply*
Gain access to treatment in foreign clinics through the Medevac program. Your health is our shared goal!
*By applying to Medevac Ukraine, you consent to the processing of personal data
Your contact details
Your treating physician’s contact information**
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