⚠️ The following form should enable the ELSAN team to precisely understand your medical needs so that they can decide whether an ELSAN solution can be provided. Before proceeding to the next stage, please check the following points: :
✅ I have a recent (< 6 months) and complete medical file (local doctor's report with history of the desease, medical background , treatments, lifestyle, symptoms, recommendations from local medical team, test results, imaging...)
✅ The documents are of good quality and contain the date of the exam, the patient's surname, first name and date of birth (verifying identity on medical documents prevents medical errors).
✅ I understand that the treatment is at the patient's expense and will be subject to prior payment of a financial estimate. In the case of a VISA request, the administrative documents (invitation and proof of payment) will only be sent once the funds have been received..
📍 It will be useful to know whether you have a geographical preference in France (please specify on the form). .