demande de premier rendes-vous

First appointment request

You are a patient or a health professional and you wish to make an online request for a first consultation appointment at the Henri-Becquerel Centre, for one of the specialities listed below. 

In order to process your request, please fill in all the necessary fields in this form.
Once registered, you will be contacted by telephone very quickly to make your appointment.

If you are already a patient at the Henri-Becquerel Centre, this form does not apply to you. Please contact the department that usually takes care of you

Hematology
Breast surgery
ENT and maxillofacial surgery
Gynecology surgery
Oncology
You are

Please contact your doctor for a prescription

To make an online request for an appointment at the hematology consultation in the Henri-Becquerel Centre please respect the following steps :

  • Please complete form below.
  • At the end of the form, you must attach the letter from the requesting doctor, the recent biological results, and possibly the recent imaging results, and the anatomopathological results, you have in your possession (PDF files only).
  • On reception of these documents, and after advice from a hematologist :
    • either an appointment will be fixed and communicated by the hematology department secretariat.
    • or a hematologist will contact the prescribing physician for follow-up.

To make an online request for an appointment at the breast surgery consultation in the Henri -Becquerel Centre please respect the following steps :

  • Please complete form below.
  • At the end of the form, you must attach the letter from the requesting doctor, the biopsy report, the report of the anatomopathological result and the recent imaging results such as mammography, breast ultrasound, breast MRI, you have in your possession (PDF files only).
  • On reception of these documents an appointment will be fixed and communicated by the breast surgery secretariat.

To make an online request for an appointment at the Gynecological surgery consultation in the Henri -Becquerel Centre please respect the following steps :

  • Please complete form below.
  • At the end of the form, you must attach the letter from the requesting doctor, and possibly the biopsy report, the report of the anatomopathological result and recent imaging results such as ultrasound, MRI, CT scan, dental panoramic, you have in your possession (PDF files only).
  • On reception of these documents an appointment will be fixed and communicated by the ENT surgery secretariat.
     

To make an online request for an appointment at the Gynecological surgery consultation in the Henri -Becquerel Centre please respect the following steps :

  • Please complete form below.
  • At the end of the form, you must attach the letter from the requesting doctor, the biopsy report, the smear report, the report of the anatomopathological result and the recent imaging results such as abdomino-pelvic ultrasound, pelvic MRI, you have in your possession (PDF files only).
  • On reception of these documents an appointment will be fixed and communicated by the Gynecological surgery secretariat.
     

To make an online request for an appointment at the Oncology consultation in the Henri-Becquerel Centre please respect the following steps :

  • Please complete form below.
  • At the end of the form, you must attach the letter from the requesting doctor, the recent biological results, and possibly the recent imaging results, and the anatomopathological results, you have in your possession (PDF files only).
  • On reception of these documents, and after advice from a oncologist :
    • Either an appointment will be fixed and communicated by the oncology department secretariat.
    • Or a oncologist will contact the prescribing physician for follow-up.
       
Patient

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Please ensure the quality and legibility of the documents sent. Only PDF and JPG files are allowed and must be under 5Mo.

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