Submit request • Sports medical examination

Organisation and contact person

You are requesting on behalf of a club, agent or employer.

Organisation *

Contact person *

Your email address *

You are requesting as

Elite membership (introductory meeting) A confidential conversation about ongoing medical support.

Transfer medical / club contract Medical examination commissioned by a club, aligned with the planning of the transfer.

Executive Health Assessment A comprehensive health assessment, as far as possible in a single day.

Medical support / second opinion Independent assessment or support by a sports physician.

Preferred date

Details / reason for request

First name *

Prefix (e.g. 'van', 'de')

Last name *

Date of birth *

For example 15-03-2008.

Gender *

Client's email address *

Phone number

The invoice goes to the organisation by default.

Who is paying?

Invoice recipient name

Invoice email

Invoice phone number

Reference / PO number

Country of invoice recipient *

VAT number (optional)

I agree to the processing of personal data by United Care Professionals in accordance with the privacy statement (v4.3-augustus-2026). *