Home  Basics of our therapy  Breast cancer  See also: General health questions
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 Phase 2-treatments  Contact/Initial questionair  See also: Dr. Kroiss' Websites

Please note!

Wir kindly ask you to keep your queries short though not neglecting any important facts.
Dr. Kroiss processes many queries. It is possible that in the future he may not be able to answer them all.
Please take also in account that legal and medical limits exist to counsel over the internet. Proper therapy plans as well as personal counsel for individual cases can only be provided by Dr. Kroiss during personal consultation in his practice. Therefore it does not make much sense to send in voluminous diagnostic findings (except Dr. Kroiss explicitly requests such in personal correspondence).
If you happen to live nearby it is advisable to call for a consultation. Should you live in farther distance it may be best you first ask if Dr. Kroiss may be able to help with such or such ailment; please briefly do state the diagnosis and former treatment with such request.
Thank you very much!

Your data for an initial assessment

In order to get a free case assessement please fill in the following form and send it to us;
please be sure to provide a valid eMail-Address to which we can respond safely.

Basic information:
Your (patient's) full name: required field
male female  Age 
If another person is writing for patient - Writer's full name: Mr.  Mrs. 
Your (patient's) home town and country:
Note: Please carefully check your input. If you do not receive an answer, it is very likely due to an errornousely entered eMail address!
Your (patient's) eMail-Address:
Your (patient's) phone/fax:
What kind of original cancer was diagnosed?
Date of first recognized indiations?  month/year

 

What Therapies have been undertaken:
year:  1st: 
result: 
year:  2nd: 
result: 
year:  3rd: 
result: 
year:  4th: 
result: 
year:  5th: 
result: 
year:  6th: 
result: 

 

Informationen about condition:
Known metastases existent? If yes: Where?
Pains? If yes: What kind & where?
Current situation?
Patient's current condition? (please select one)  100: Normal  90: Able to carry on normal activity; minor symptoms of disease
 80: Normal activity with effort; some symptoms of disease  70: Cares for self; unable to carry on normal activity or active work
 60: Requires occasional assistance but is able to care for needs  50: Requires considerable assistance and frequent medical care
 40: Disabled; requires special care and assistance  30: Severely disabled; hospitalization is indicated
 20: Very sick; hospitalization necessary; active treatment necessary  10: Moribund; fatal processes progressing rapidly
Patient's current medication:
Other current illnesses:

 

Patient´s information:
Patient needs special care  ...
Patient could travel  ... to Austria: Yes  No 
Patient would come ... alone  not alone 
Accomodation wanted ...
Patient wants to know ...   Chances of treatment by Dr. Kroiss
  Estimated length of treatment in Vienna
  Estimated length of treatment back home
  Estimated cost of treatment
  Expected result of treatment
Personal communication to Dr. Kroiss:

 

Note: Your data will be treated confidential und not submited to others.