Tele-consultation Make an appointment

ONLINE FORM

In 4 simple steps, you can determine if your back problems require a surgical consultation

Fill in your form and receive free advice on your case from our surgeons within 7 days

1. Your symptoms

  • Main problem
  • Date of first symptoms:
  • Permanent pain since (if applicable):
  • Do you have pain in your arms or legs (sciatica, cruralgia, neuralgia)?
    If yes, please tick the relevant limbs:
    Right Left
  • Is it the main pain?
  • Do you have tingling or numbness in any of your limbs?
  • If yes, since when?
  • Do you have a significant loss of strength in any of your limbs?
  • If yes, since when?
    • Tell us in a few words in what ways your symptoms disable you most:

2. Your completed treatments

Indicate any medication you have taken for your pain (if applicable)
Physiotherapy or osteopathy
Brace or lumbar belt
Inpatient stay
Infiltration or thermocoagulation
Rheumatology or specialist medical check-up
List previous spinal surgeries and dates (if applicable)

3. Your images

You may also send us your most recent images (Scans, X-rays, etc.) using one of the following methods:

Are your images on a CD?

Send us all the files on your CD:

J’envoie les images de mon CD

Send your images to the CCV Montpellier for a teleconsultation

1. Copy the CD of your examination (scanner, MRI, etc) to your computer. A folder with the CD name will be automatically generated.

2. Drag this folder into the area below. Or click on the "Folders and Disks" button and select the folder corresponding to your CD.
The images are uploaded automatically.

CT and MRI files often contain a lot of images and can take several minutes to upload, this is normal.

3. Once your images have been sent, the loading bar disappears and the description of the images appears. The CCV Montpellier will have access to "your images".

4. You can close this window and finish filling in the medical advice form.

You can also send us your images by post:

CCV MONTPELLIER
AVIS MEDICAL
Clinique du parc - 50 Rue Emile Combes,
34170 Castelnau-le-Lez

Have you received a link to view your images online?

Paste your link below with your login and password:

Requests for a medical opinion will only be considered with related medical imaging.

4. Your information

Sexe :
Size
cm
Weight:
kg
If occupational accident, date occurred?
Are you looking for surgical solutions for your back problem?
Do you have a specific message (or request) for us?
or I wish to send it to a specific surgeon:

For your information

Teleconsultation is governed by articles L.6316-1 and R.6316-1 of the French Public Health Code and by the decree of August 1, 2018 approving amendment no. 6 to the national agreement organising relations between private doctors and the health insurance scheme signed on August 25, 2016. Please note that if you are consulting with the CCV for the first time (you have never seen one of the surgeons in consultation at the practice before), the teleconsultation will not be covered by health insurance and you will have to pay for it yourself with no possibility of refund (€150, see the tariffs section).