Clinical case submission - Owner

Contact purpose

Owner information

Patient Information

Clinical case Description

(Relevant information: How long ago was the trauma? How long does the patient had the symptoms? How has the case progressed since the onset of symptoms/trauma? Has the patient been evaluated by a general practitioner? Has a previous diagnosis been made?)

UPload Relevant Documents

(If you have any of this information, upload or drag the file to the respective areas).

Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
Click or drag a file to this area to upload.