Step prior to care

Personal data for your attention

Enter your details and open the prepared message for the doctor. In WhatsApp, you only need to tap Send.

Is this your first consultation with the Dr. Dino González?

Yes, I am a New Patient Complete demographic data for the first time.

No, I am a Recurring Patient I have already taken care of myself. Fill only reason and news.

1. Personal data

Full name * RUT * Date of birth * Age * Contact phone * Email (optional) Health insurance * Address or commune of residence (optional)

2. Control consultation data

Current reason for consultation * Changes or news since your last service (Optional)

5. Consent and security I understand that this form prepares the teleconsultation, but it does not replace direct medical evaluation nor does it constitute a medical indication in itself. * I agree to prepare my details in a WhatsApp link addressed to Dr. Dino González. I will review the message and decide whether to send it; the doctor will review the details before adding them to my medical record. *