Appointments

Welcome to the Appointment Center at Shaare Zedek Medical Center

Please fill out all your details and a representative will get back to you to schedule your appointment.
You may also contact us by phone at 972-2-6555999 or download this form in PDF format and fax it to 972-2-6555993.

Wishing you the best of health,
The Appointment Center Staff

Required fields are marked with *

^*First Name

Required Field שדה לא תקין

^*Last Name

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Identity Type ID Passport

^*ID Number

Required Field IDWrong

^*Requested Field

Required Field

^*Father's Name

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^*Phone Number

Required Field 7Digits:Missing 7Digits:Missing

Fax Number

7Digits:Missing 7Digits:Missing

^*Email

Required Field Email Invalid

Gender Male Female

^*Year of Birth

Required Field

^*Address

Required Field At Least 2 Char

^*City

Required Field At Least 2 Char

^*Zipcode

Required Field 7Digits:Missing 7Digits:Missing

Clinic Type

Which Doctor Saw You in the Past

^*Preferred Method of Communication

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