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HOSPITAL PRE-ADMISSION  
Chapultepec Unit

* This form only applies within 48 hours prior to entry.

Patient's data

Place of birth

Address

Responsible for the Patient

Address of the Responsible

What phone number do you want us to contact to follow up on your pre-admission, and at what time:

En procedimientos quirúrgicos (incluyendo procedimientos de: Hemodinamia, Endoscopia y/o Hemodialisis) podemos realizarle la prueba rápida antígeno SARS-CoV2 de manera gratuita el día de su ingreso.

¡Por su seguridad y la de todos!

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