EnglishDeutsch (German) We look forward to your message Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Your name *First nameSurnameE-mail-address: *EmailConfirm EmailWhere do you come from?AfghanistanAlbaniaAlgeriaAmerican SamoaAmerican Virgin IslandsAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAzerbaijanAustraliaBahamasBahrainBangladeshBarbadosBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational state)Bonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Virgin IslandsBritish territory in the Indian OceanBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeChileChinaCook IslandsCosta RicaCuraçaoCôte d'IvoireGermanyDjiboutiDominicaDominican RepublicDenmarkEcuadorEl SalvadorEritreaEstoniaEswatini (Kingdom)Falkland Islands (Malvinas)FijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern and Antarctic TerritoriesFaroe IslandsGabonGambiaGeorgiaGhanaGibraltarGrenadaGreeceGreenlandGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHondurasHong KongIndiaIndonesiaIraqIran (Islamic Republic of)IrelandIcelandIsle of ManIsraelItalyJamaicaJapanYemenJerseyJordanCayman IslandsCambodiaCameroonCanadaKazakhstanQatarKenyaKyrgyzstanKiribatiCocos Islands (Keeling Islands)ColombiaComorosCongo (Democratic Republic of)Congo (Republic of)Korea (Democratic People's Republic of)Korea (Republic of)KosovoCroatiaCubaKuwaitLaos (People's Democratic Republic)LesothoLatviaLebanonLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMoroccoMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldova (Republic of)MonacoMongoliaMontenegroMontserratMozambiqueMyanmarNamibiaNauruNepalNew CaledoniaNew ZealandNicaraguaNetherlandsNigerNigeriaNiueNorth Macedonia (Republic of)Norfolk IslandNorwayNorthern Mariana IslandsOmanEast TimorPakistanPalauPalestine (state)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoRwandaRomaniaRussiaRéunionSaint-BarthélemySaint-Pierre and MiquelonSolomon IslandsZambiaSamoaSan MarinoSaudi ArabiaSwedenSwitzerlandSenegalSerbiaSeychellesSierra LeoneZimbabweSingaporeSint MaartenSlovakiaSloveniaSomaliaSpainSpitsbergenSri LankaSt. Helena, Ascension and Tristan da CunhaSt. Kitts and NevisSt. LuciaSt. Martin (French)St. Vincent and the GrenadinesSudanSurinameSyria (Arab Republic)São Tomé and PríncipeSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanTajikistanTaiwan, Republic of ChinaTanzania (United Republic of)ThailandTogoTokelauTongaTrinidad and TobagoChadCzech republicTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTurkeyUSAUgandaUkraineHungaryUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican City (State)Venezuela (Bolivarian Republic of)United Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandVietnamWallis and FutunaChristmas IslandBelarusWestern SaharaCentral African RepublicCyprusEgyptEquatorial GuineaEthiopiaÅland IslandsAustriaPhone number *How may we contact you? *e-mailTelephoneI would like to know more about: *Prostate cancerProstate cancer recurrenceBenign prostatic hyperplasiaBladder cancerOtherGender *ManWomanOtherMessage *Please answer the security question: *Which number is bigger: 3 or 8? Send Contact VITUS PRIVATE CLINIC E-Mail-Adress:international@vitusprivatklinik.com International Counselling:+49 (0)177 23 82 863 FAX:+49 69 50 50 00 988 Strahlenbergerstraße 11063067 Offenbach am MainHessen / Germany
