Hospitalization Request

Who Can Make a Request for Hospitalization

The request for hospitalization in agreement with the National Health Service (SSN) may be sent to the Santa Lucia Foundation IRCCS exclusively by the hospital, where the patient is hospitalized. Private Hospitalization can be requested also by a physician for a not hospitalized patient. False declarations will be subject to criminal prosecution (art. 482 Italian Criminal Code). The Santa Lucia Foundation IRCCS send feedback to the hospital or requesting physician within an average of 24 working hours.


How to send the Form

The Form for Hospitalization Request must be completed and sent by email to The electronic completion of Form involves the insertion of the digital signature of the applicant. The operation is simple. If you need assistance, follow the instructions for creating and inserting digital signature in pdf-documents. In case of difficulty, the Request for Hospitalization can be faxed to (+39) 06.5032097.


➤   Download the FORM FOR HOSPITALIZATION REQUEST for a patient you treated

(To be able to complete and digitally sign the form, this must be saved on your computer)