Portal del paciente del Hospital General de Villalba

Please register in order to enjoy our services

Fill in the following form and send it off.

You will receive the access password by SMS

On your first access you will be able to change the password

Access details

Personal details

These are the details you will use to log on the Patient Portal

You will be able to register patients under tutelage once you are logged on

Name (*)

Surname (1) (*)

Surname (2)

If you have a second surname, please specify.

Date of birth (*)

Gender (*)

Male

Female

Type of identity document (*)

ID number (*)

Mobile phone (*)

Email (*)

You will use this email to enter your account.

Save and continue

Remember that in order to access the data of another person must have legal authorization of access to the data, either because it is a child under 16 and you are your parent or legal guardian or because you are a disabled adult and To have a judicial decision granting the guardianship or guardianship of the same, as well as judicial resolution granted by parental authority in cases of divorce.

Name

Surname (1)

Surname (2)

if you have a second surname, make sure you fill in this field to verify the authenticity of your personal data.

Date of birth (MM/DD/YYYY)

Gender (*) Male Female

The date entered is not valid. Example: 07/25/1980

Only those over 16 years old can register.

ID document :

ID number :

Photograph

It is not necessary to upload a photograph. If you choose to upload one, the photograph must be in jpg, gif or png format, and no larger than 1MB. Recommended size: 142x150 px.

Fill in your personal details

Home

Country (*)

Province (*)

Population (*)

Postal Code (*)

Type of via (*)

Via (*)

No. (*)

Other (level / floor / Block)

I have read and accept the Privacy Policy and Terms of Use and I declare that I am over 16 years old *

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