Prescriptions for psychotherapy to WePractice

With a referral to WePractice, you ensure that your patients are promptly treated by our psychotherapists. Please use the form below for this purpose. Fields marked with an * are mandatory to fill out. Of course, data transmission is encrypted.

Please inform your patients about the referral to WePractice. A therapy place is not guaranteed. If patients cannot be placed within 2-3 weeks, both you as the referrer and the patient will be informed by email.

If you encounter any problems with the form, you can also send the prescriptions to praxis@wepractice.ch . However, form submissions are preferred.

Patient information

Fields marked with * are mandatory. Your information will be transmitted in encrypted form.

Last name *

First name *

Date of birth

Phone number *

Preferred location(s) *

Choose one or more locations

Preferred language(s) *

Choose a language

Reasons(s) for treatment*

ADD / ADHD (attentional disorder)

Affective (mood) disorder (depression / mania / burnout)

Anxiety disorder/PTSD

Adjustment disorder / Sleeping problems

Autism spectrum disorder / Developmental disorder

Eating disorder

Crisis / Conflicts / Difficulties in social behavior

Personality disorder

Psychosomatic disorder

Addictive disorder

Obsessive compulsive disorder (OCD) / Tics

Other

Problem description and other remarks

Upload prescription for psychotherapy*

Please upload the signed prescription ("Anordnung") for the patient.

If you do not have a template of the prescription, you can download it here.

Drop the prescription for psychotherapy and any other relevant files here. Maximum upload limit for all your uploaded documents: 20MB.

Choose a file

Details of the referring person or practice

Fields marked with * are mandatory. Your information will be transmitted in encrypted form.

Last name *

First name *

Practice / Clinic / Hospital *

Phone number *

Email *

The personal data will be processed in accordance with our data privacy notice.