Welcome to the
online registration

As a patient at the Zollikerberg Hospital or at the birthing center Zollikerberg, we will guide you through the administrative online registration process below.

1

Health insurance card

2

Personal information

3

Contact person

4

General practitioner

5

Reason for admission

6

Insurance details

7

Activity

8

Authorizations

9

Review & submit

Online registration

Prerequisites for online registration

  • You already have an appointment at the Zollikerberg Hospital or at the birthing center Zollikerberg.
  • You have Swiss health insurance (KVG) with an health insurance card.

Data Entry

  • If you already have been admitted to the Hospital as an inpatient this year and your information has not changed since then, you do not need to complete the online registration anymore.

Alternative

If you prefer to register in person instead of online, we kindly ask you to arrive at the reception desk (as indicated in your invitation) with your insurance documents and an official ID 20 minutes before your appointment.

1. Health insurance card

The health insurance card is only used for authentication. Any accident insurance can then be recorded under “insurance relationship”.

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The new card number has already been stored:
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Would you like to use the new card number?

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2. Personal information

Please enter your personal information according to your official identity document (identity card, passport, or foreigner's permit).

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Address

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Different mailing address?

Use your own name?

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3. Contact person

Would you like to keep or delete any previously specified contact persons?

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Please provide the contact information of a person we can reach in case of an emergency.

First contact person

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Use your own address?

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Second contact person

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Use your own address?

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4. General practitioner

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Search for a general practitioner

Search for your general practitioner in the list. If you cannot find your general practitioner, you can add your own general practitioner below.

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Add a general practitioner

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5. Reason for admission

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Referral

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Search for referring physician

Search for your physician in the list. If you cannot find your physician, you can add your own physician below.

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Add referring physician

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6. Insurance relationship

Accident insurance

Health insurance

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Do you have a flexible or choice insurance?

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For flexible or choice insurances, full costs are covered for the general department. For the semi-private or private department, your financial contribution is required. The amount of this financial contribution has been contractually agreed with your insurance. Please contact your health insurance company for more detailed information regarding your cost-sharing model.

I have read and understood the information on flexible and choice insurance.

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Select in the field below under Insurance coverage how you wish to enter.

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Outpatient supplementary insurance:
Please let us know before your admission if you have any of the following outpatient supplementary insurances:

- Hospital Day Comfort by Sanitas
- PRIMEO by Helsana
- myFlex by CSS

HP (Advanced):
As a semi-private insured, you are entitled to treatment by specialists at the level of chief physician, senior physician, or attending physician, a quiet single room of comfort or standard category with a view of greenery, as well as other services analogous to your policy and our offer.

Private (Excellence):
As a private insured, you are entitled to a deluxe single room and free choice of doctor, as well as other services analogous to your policy and our offer.

Supplementary insurance

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Newborn health insurance

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Newborn supplementary insurance

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7. Activity

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Would you like to provide information about your activity? (optional)

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8. Authorizations

Electronic patient record

Do you have an electronic patient record (EPR)?

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Please authorize Zollikerberg Hospital (including birthing center Zollikerberg) and its staff to access your electronic patient record before the start of treatment.

Do you wish to exclude this case for the upcoming treatment?

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In case of a case exclusion, no documents related to this medical case will be uploaded to your EPR by the hospital or the birthing center.

Data Protection and Communication

We place great importance on protecting your personal data and strictly adhere to the principles of data minimization. Your information will be used exclusively in the context of treatment and in accordance with applicable legal provisions (see Articles 320 and 321 of the Swiss Criminal Code (SCC) as well as Article 16 of the Patients’ Act of the Canton of Zurich).

Cost assurance

The Zollikerberg Hospital and the birthing center Zollikerberg are obligated to provide your health insurance or insurer with the necessary medical information for evaluating liability for services. If there is no or insufficient insurance coverage for your treatment and stay, you are responsible for covering the uninsured costs.

Liability

The hospital and the birthing center accept no liability for lost items and valuables not deposited in the safe. The place of jurisdiction is Zollikon and Swiss law applies.

9. Review & submit

1. Health insurance card

Insurance card number: ${formdata.personalangaben.versicherungskartenummer}

I do not have a health insurance card.

2. Personal information

Salutation: ${getFieldLabel('anrede', formdata.personalangaben.anrede)}
Last name: ${formdata.personalangaben.nachname}
First name(s): ${formdata.personalangaben.vorname}
Maiden name: ${formdata.personalangaben.geburtsname}
Date of birth: ${formdata.personalangaben.geburtsdatum}
Sex: ${getFieldLabel('geschlecht', formdata.personalangaben.geschlecht)}
Marital status: ${getFieldLabel('zivilstand', formdata.personalangaben.zivilstand)}
Nationality: ${getFieldLabel('land', formdata.personalangaben.staatsangehoerigkeit)}
Place of birth: ${formdata.personalangaben.heimatort}
Religion: ${getFieldLabel('konfession', formdata.personalangaben.konfession)}

Street: ${formdata.personalangaben.adresse.strasse}
House number: ${formdata.personalangaben.adresse.hausnummer}
Postal code: ${formdata.personalangaben.adresse.plz}
City: ${formdata.personalangaben.adresse.ort}
Country: ${getFieldLabel('land', formdata.personalangaben.adresse.land)}
Phone number: ${formdata.personalangaben.kontaktinformationen.telefonnummer}
Mobile number: ${formdata.personalangaben.kontaktinformationen.mobilenummer}
Email address: ${formdata.personalangaben.kontaktinformationen.emailadresse}

Different correspondence address

Last name: ${formdata.personalangaben.abweichendekorrespondenzadresse.nachname}
First name(s): ${formdata.personalangaben.abweichendekorrespondenzadresse.vorname}
c/o: ${formdata.personalangaben.abweichendekorrespondenzadresse.co}
Street: ${formdata.personalangaben.abweichendekorrespondenzadresse.adresse.strasse}
House number: ${formdata.personalangaben.abweichendekorrespondenzadresse.adresse.hausnummer}
Postal code: ${formdata.personalangaben.abweichendekorrespondenzadresse.adresse.plz}
City: ${formdata.personalangaben.abweichendekorrespondenzadresse.adresse.ort}
Country: ${getFieldLabel('land', formdata.personalangaben.abweichendekorrespondenzadresse.adresse.land)}

3. Contact person

Keep contact persons: ${formdata.angehoerige_behalten ? 'Yes' : 'No'}

No relatives specified.

First contact person

Degree of relationship: ${getFieldLabel('verwandtschaftsgrad', formdata.angehoerige[0].verwandtschaftsgrad)}
Salutation: ${getFieldLabel('anrede', formdata.angehoerige[0].anrede)}
Last name: ${formdata.angehoerige[0].nachname}
First name(s): ${formdata.angehoerige[0].vorname}

Use your own address?: ${formdata.angehoerige[0].adresseuebernehmen ? 'Yes' : 'No'}

Street: ${formdata.angehoerige[0].adresse.strasse}
House number: ${formdata.angehoerige[0].adresse.hausnummer}
Postal code: ${formdata.angehoerige[0].adresse.plz}
City: ${formdata.angehoerige[0].adresse.ort}
Country: ${getFieldLabel('land', formdata.angehoerige[0].adresse.land)}
Phone number: ${formdata.angehoerige[0].kontaktinformationen.telefonnummer}
Mobile number: ${formdata.angehoerige[0].kontaktinformationen.mobilenummer}
Email address: ${formdata.angehoerige[0].kontaktinformationen.emailadresse}

Second contact person

Degree of relationship: ${getFieldLabel('verwandtschaftsgrad', formdata.angehoerige[1].verwandtschaftsgrad)}
Salutation: ${getFieldLabel('anrede', formdata.angehoerige[1].anrede)}
Last name: ${formdata.angehoerige[1].nachname}
First name(s): ${formdata.angehoerige[1].vorname}

Use your own address?: ${formdata.angehoerige[1].adresseuebernehmen ? 'Yes' : 'No'}

Street: ${formdata.angehoerige[1].adresse.strasse}
House number: ${formdata.angehoerige[1].adresse.hausnummer}
Postal code: ${formdata.angehoerige[1].adresse.plz}
City: ${formdata.angehoerige[1].adresse.ort}
Country: ${getFieldLabel('land', formdata.angehoerige[1].adresse.land)}
Phone number: ${formdata.angehoerige[1].kontaktinformationen.telefonnummer}
Mobile number: ${formdata.angehoerige[1].kontaktinformationen.mobilenummer}
Email address: ${formdata.angehoerige[1].kontaktinformationen.emailadresse}

4. General practitioner

I don't have a general practitioner

General practitioner: ${getFieldLabel('hausaerzte', formdata.hausarzt.preselection)}

Last name: ${formdata.hausarzt.nachname}
First name(s): ${formdata.hausarzt.vorname}
Street: ${formdata.hausarzt.adresse.strasse}
House number: ${formdata.hausarzt.adresse.hausnummer}
Postal code: ${formdata.hausarzt.adresse.plz}
City: ${formdata.hausarzt.adresse.ort}
Country: ${getFieldLabel('land', formdata.hausarzt.adresse.land)}
Phone number: ${formdata.hausarzt.kontaktinformationen.telefonnummer}
Email address: ${formdata.hausarzt.kontaktinformationen.emailadresse}

5. Reason for admission

Reason for admission: ${getFieldLabel('besuchsgrund', formdata.besuchsgrund.grund)}

Date of accident: ${formdata.besuchsgrund.unfalldatum}
Accident number: ${formdata.besuchsgrund.unfallnummer}

Self-Admission: ${formdata.besuchsgrund.selbsteinweisung ? 'Yes' : 'No'}
Referred by general practitioner: ${formdata.besuchsgrund.arzteinweisung.hausarzt ? 'Yes' : 'No'}

Referring physician

${getFieldLabel('aerzte', formdata.besuchsgrund.arzteinweisung.preselection)}

Referring physician

Last name: ${formdata.besuchsgrund.arzteinweisung.nachname}
First name(s): ${formdata.besuchsgrund.arzteinweisung.vorname}
Street: ${formdata.besuchsgrund.arzteinweisung.adresse.strasse}
House number: ${formdata.besuchsgrund.arzteinweisung.adresse.hausnummer}
Postal code: ${formdata.besuchsgrund.arzteinweisung.adresse.plz}
City: ${formdata.besuchsgrund.arzteinweisung.adresse.ort}
Country: ${getFieldLabel('land', formdata.besuchsgrund.arzteinweisung.adresse.land)}
Phone number: ${formdata.besuchsgrund.arzteinweisung.kontaktinformationen.telefonnummer}
Email address: ${formdata.besuchsgrund.arzteinweisung.kontaktinformationen.emailadresse}

6. Insurance relationship

Health insurance provider: ${getFieldLabel('versicherungen', formdata.versicherungsverhaeltnis.versicherungsname)}

Insurance card number: ${formdata.versicherungsverhaeltnis.versicherungskartenummer}

Insurance number (optional): ${formdata.versicherungsverhaeltnis.versicherungsnummer}

Flexible or choice insurance: ${formdata.versicherungsverhaeltnis.flex ? 'Yes' : 'No'}

I have read and understood the information on flexible and choice insurance: ${formdata.einverstaendnis.flex ? 'Yes' : 'No'}

Insurance coverage: ${getFieldLabel('versicherungsdeckung', formdata.versicherungsverhaeltnis.deckung.deckung)}

Supplementary insurance

Health insurance provider: ${getFieldLabel('zusatzversicherungen', formdata.versicherungsverhaeltnis.deckung.zusatzversicherung.versicherungsname)}
Policy / Customer Number: ${formdata.versicherungsverhaeltnis.deckung.zusatzversicherung.policennummer}

Newborn health insurance

Health insurance provider: ${getFieldLabel('versicherungen', formdata.versicherungsverhaeltnis.neugeborenes.versicherungsname)}
Policy / Customer Number: ${formdata.versicherungsverhaeltnis.neugeborenes.policennummer}
Insurance coverage: ${getFieldLabel('versicherungsdeckung', formdata.versicherungsverhaeltnis.neugeborenes.deckung.deckung)}

Newborn supplementary insurance

Health insurance provider: ${getFieldLabel('zusatzversicherungen', formdata.versicherungsverhaeltnis.neugeborenes.deckung.zusatzversicherung.versicherungsname)}
Policy / Customer Number: ${formdata.versicherungsverhaeltnis.neugeborenes.deckung.zusatzversicherung.policennummer}

7. Activity

Activity: ${getFieldLabel('anstellungsverhaeltnise', formdata.arbeitgeber.anstellungsverhaeltnis)}

No employer specified.

Occupation: ${formdata.arbeitgeber.beruf}
Company name: ${formdata.arbeitgeber.name}
Street: ${formdata.arbeitgeber.adresse.strasse}
House number: ${formdata.arbeitgeber.adresse.hausnummer}
Postal code: ${formdata.arbeitgeber.adresse.plz}
City: ${formdata.arbeitgeber.adresse.ort}
Country: ${getFieldLabel('land', formdata.arbeitgeber.adresse.land)}
Phone number: ${formdata.arbeitgeber.kontaktinformationen.telefonnummer}
Email address: ${formdata.arbeitgeber.kontaktinformationen.emailadresse}

8. Authorizations

Electronic patient record: ${formdata.epd.selected ? 'Yes' : 'No'}

Confirmation

I hereby confirm the accuracy of the information provided. It is not possible to claim at a later point in time that I made an error or misjudged the insurance coverage.

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Your registration is being processed...

Registration successful

Thank you for your registration. Your personal data has been recorded, and your check-in is ready. We wish you a pleasant stay and a speedy recovery at Zollikerberg Hospital.

If you have any further questions or need assistance, our staff is here to help.

Help with registration

anmeldung@​spital​zollikerberg.ch

T: 044 397 21 11