The undersigned
According to the National Collective Agreement on General Medicine, applies to choose by derogating residence, for his/herself and for his/her relatives:
General Practitioner’s data:
Registered in the GP list of the following city:
Otherwise, the Health District Registry Office will check if the doctor You have chosen can accept You as his/her patient, which can happen only in the following circumstances:
  • To pursue a trustful relationship
  • For reasons of proximity or better viability than the previous GP’s office
  • Serious and objective circumstances hindering health care delivery (specify)
  • Serious and specific illnesses

as long as the doctor has not exceeded his/her maximum number of patients.
Please note: If you have chosen a pediatrician belonging to a different Health Authority, you need to upload the consent of the Health Authority the new pediatrician is enrolled in, as well.
I have read the privacy policy on personal and health data treatment in AULSS 3 Internet site at the following link  and I agree to my personal data treatment for administrative purposes, according to the European Regulation (GDPR n. 2016/679) and Italian Privacy Code (D.Lgs. n. 196/2003, as amended and supplemented by D.L. n. 101/2018).