iMER
Patient Self Registration
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Manual Patient Self Registration
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Submission Date
(Required)
DD slash MM slash YYYY
Patient Information
Full Name
(Required)
First
Last
Telephone
(Required)
Email
The registration fee for patients using iMER services is a fixed rate of €150. This fee covers the administrative processing of medical registration and applies to all patients, regardless of the registration method selected.
Forms Uploading
Patient Registration
(Required)
Please click here to download the Registration Form, fill it in manually and then upload a completed (scanned) copy in the following file-upload field.
Accepted file types: pdf, png, jpg, Max. file size: 15 MB.
Medical Questionnaire
(Required)
Accepted file types: pdf, png, jpg, Max. file size: 15 MB.
Registration Fees
Payment Options
(Required)
Bank Transfer
Online Payment
Bank Name:
Eurobank
Beneficiary:
iMER Medical Services Ltd
Account Number:
001-00002411
IBAN:
CY42 0180 0008 0000 3001 0000 2411
SWIFT:
ERBKCY2N
Please send deposit slip to iMER by fax or email.
Please remember to indicate the patient’s name as reference on the deposit slip.
Open iMER Payments
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Download Registration Form
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