Form for public sector agency/insurance company

Please do not submit patient data or other confidential information such as a medical records, medical information, diagnosis or financial situation via this form.

First name Last name:* (mandatory)

E-mail address:* (mandatory)

Phone number:* (mandatory)

Invoice number:

Subject:* (mandatory)

Description:* (mandatory)

Attach file:

Last updated: 9 February 2024

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Region Skåne

Form for public sector agency/insurance company

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