Formulario di richiesta Formulario di richiesta di perizia extragiudiziaria all’Ufficio perizie della FMH Importante: Vogliate p.f. compilare il formulario in modo esatto, completo e accurato. L’invio del formulario di richiesta di perizia apre la procedura formale presso l’Ufficio perizie; una domanda incompleta non potrà essere trattata. Registrazione — Passi 1 del 9 Cognome e Nome* Numero di cellulare per l'autorizzazione tramite sms* +41 075 076 077 078 079 > Indicare un numero internazionale +49 – Germany (Deutschland) +39 – Italy (Italia) +33 – France +423 – Liechtenstein +43 – Austria (Österreich) ------------------ +93 – Afghanistan (افغانستان) +355 – Albania (Shqipëri) +213 – Algeria (الجزائر) +1 – American Samoa +376 – Andorra +244 – Angola +1 – Anguilla +1 – Antigua and Barbuda +54 – Argentina +374 – Armenia (Հայաստան) +297 – Aruba +61 – Australia +43 – Austria (Österreich) +994 – Azerbaijan (Azərbaycan) +1 – Bahamas +973 – Bahrain (البحرين) +880 – Bangladesh (বাংলাদেশ) +1 – Barbados +375 – Belarus (Беларусь) +32 – Belgium (België) +501 – Belize +229 – Benin (Bénin) +1 – Bermuda +975 – Bhutan (འབྲུག) +591 – Bolivia +387 – Bosnia and Herzegovina (Босна и Херцеговина) +267 – Botswana +55 – Brazil (Brasil) +246 – British Indian Ocean Territory +1 – British Virgin Islands +673 – Brunei +359 – Bulgaria (България) +226 – Burkina Faso +257 – Burundi (Uburundi) +855 – Cambodia (កម្ពុជា) +237 – Cameroon (Cameroun) +1 – Canada +238 – Cape Verde (Kabu Verdi) +599 – Caribbean Netherlands +1 – Cayman Islands +236 – Central African Republic (République centrafricaine) +235 – Chad (Tchad) +56 – Chile +86 – China (中国) +61 – Christmas Island +61 – Cocos (Keeling) Islands +57 – Colombia +269 – Comoros (جزر القمر) +243 – Congo (DRC) (Jamhuri ya Kidemokrasia ya Kongo) +242 – Congo (Republic) (Congo-Brazzaville) +682 – Cook Islands +506 – Costa Rica +225 – Côte d’Ivoire +385 – Croatia (Hrvatska) +53 – Cuba +599 – Curaçao +357 – Cyprus (Κύπρος) +420 – Czech Republic (Česká republika) +45 – Denmark (Danmark) +253 – Djibouti +1 – Dominica +1 – Dominican Republic (República Dominicana) +593 – Ecuador +20 – Egypt (مصر) +503 – El Salvador +240 – Equatorial Guinea (Guinea Ecuatorial) +291 – Eritrea +372 – Estonia (Eesti) +251 – Ethiopia +500 – Falkland Islands (Islas Malvinas) +298 – Faroe Islands (Føroyar) +679 – Fiji +358 – Finland (Suomi) +33 – France +594 – French Guiana (Guyane française) +689 – French Polynesia (Polynésie française) +241 – Gabon +220 – Gambia +995 – Georgia (საქართველო) +49 – Germany (Deutschland) +233 – Ghana (Gaana) +350 – Gibraltar +30 – Greece (Ελλάδα) +299 – Greenland (Kalaallit Nunaat) +1 – Grenada +590 – Guadeloupe +1 – Guam +502 – Guatemala +44 – Guernsey +224 – Guinea (Guinée) +245 – Guinea-Bissau (Guiné Bissau) +592 – Guyana +509 – Haiti +504 – Honduras +852 – Hong Kong (香港) +36 – Hungary (Magyarország) +354 – Iceland (Ísland) +91 – India (भारत) +62 – Indonesia +98 – Iran (ایران) +964 – Iraq (العراق) +353 – Ireland +44 – Isle of Man +972 – Israel (ישראל) +39 – Italy (Italia) +1 – Jamaica +81 – Japan (日本) +44 – Jersey +962 – Jordan (الأردن) +7 – Kazakhstan (Казахстан) +254 – Kenya +686 – Kiribati +383 – Kosovo +965 – Kuwait (الكويت) +996 – Kyrgyzstan (Кыргызстан) +856 – Laos (ລາວ) +371 – Latvia (Latvija) +961 – Lebanon (لبنان) +266 – Lesotho +231 – Liberia +218 – Libya (ليبيا) +423 – Liechtenstein +370 – Lithuania (Lietuva) +352 – Luxembourg +853 – Macau (澳門) +389 – Macedonia (FYROM) (Македонија) +261 – Madagascar (Madagasikara) +265 – Malawi +60 – Malaysia +960 – Maldives +223 – Mali +356 – Malta +692 – Marshall Islands +596 – Martinique +222 – Mauritania (موريتانيا) +230 – Mauritius (Moris) +262 – Mayotte +52 – Mexico (México) +691 – Micronesia +373 – Moldova (Republica Moldova) +377 – Monaco +976 – Mongolia (Монгол) +382 – Montenegro (Crna Gora) +1 – Montserrat +212 – Morocco (المغرب) +258 – Mozambique (Moçambique) +95 – Myanmar (Burma) (မြန်မာ) +264 – Namibia (Namibië) +674 – Nauru +977 – Nepal (नेपाल) +31 – Netherlands (Nederland) +687 – New Caledonia (Nouvelle-Calédonie) +64 – New Zealand +505 – Nicaragua +227 – Niger (Nijar) +234 – Nigeria +683 – Niue +672 – Norfolk Island +850 – North Korea (조선 민주주의 인민 공화국) +1 – Northern Mariana Islands +47 – Norway (Norge) +968 – Oman (عُمان) +92 – Pakistan (پاکستان) +680 – Palau +970 – Palestine (فلسطين) +507 – Panama (Panamá) +675 – Papua New Guinea +595 – Paraguay +51 – Peru (Perú) +63 – Philippines +48 – Poland (Polska) +351 – Portugal +1 – Puerto Rico +974 – Qatar (قطر) +262 – Réunion (La Réunion) +40 – Romania (România) +7 – Russia (Россия) +250 – Rwanda +590 – Saint Barthélemy +290 – Saint Helena +1 – Saint Kitts and Nevis +1 – Saint Lucia +590 – Saint Martin (Saint-Martin (partie française)) +508 – Saint Pierre and Miquelon (Saint-Pierre-et-Miquelon) +1 – Saint Vincent and the Grenadines +685 – Samoa +378 – San Marino +239 – São Tomé and Príncipe (São Tomé e Príncipe) +966 – Saudi Arabia (المملكة العربية السعودية) +221 – Senegal (Sénégal) +381 – Serbia (Србија) +248 – Seychelles +232 – Sierra Leone +65 – Singapore +1 – Sint Maarten +421 – Slovakia (Slovensko) +386 – Slovenia (Slovenija) +677 – Solomon Islands +252 – Somalia (Soomaaliya) +27 – South Africa +82 – South Korea (대한민국) +211 – South Sudan (جنوب السودان) +34 – Spain (España) +94 – Sri Lanka (ශ්රී ලංකාව) +249 – Sudan (السودان) +597 – Suriname +47 – Svalbard and Jan Mayen +268 – Swaziland +46 – Sweden (Sverige) +963 – Syria (سوريا) +886 – Taiwan (台灣) +992 – Tajikistan +255 – Tanzania +66 – Thailand (ไทย) +670 – Timor-Leste +228 – Togo +690 – Tokelau +676 – Tonga +1 – Trinidad and Tobago +216 – Tunisia (تونس) +90 – Turkey (Türkiye) +993 – Turkmenistan +1 – Turks and Caicos Islands +688 – Tuvalu +1 – U.S. Virgin Islands +256 – Uganda +380 – Ukraine (Україна) +971 – United Arab Emirates (الإمارات العربية المتحدة) +44 – United Kingdom +1 – United States +598 – Uruguay +998 – Uzbekistan (Oʻzbekiston) +678 – Vanuatu +39 – Vatican City (Città del Vaticano) +58 – Venezuela +84 – Vietnam (Việt Nam) +681 – Wallis and Futuna (Wallis-et-Futuna) +212 – Western Sahara (الصحراء الغربية) +967 – Yemen (اليمن) +260 – Zambia +263 – Zimbabwe +358 – Åland Islands > Indicare un numero svizzero E-mail* Richiedente Paziente Rappresentante Rappresentante legale Dichiarazione di consenso* Dichiaro di accettare la 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Le informazioni inserite e i documenti allegati vengono salvati sul server e trasmessi all’Ufficio perizie della FMH per l’elaborazione. Registrazione * Campo obbligatorio