Prescriptions for psychotherapy to WePractice

With a prescription for psychotherapy to WePractice, you ensure that your patient is treated promptly by one of our therapists. Please fill out the form below.

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

If you encounter any problems with the form, you can also send the prescriptions to ueberweisung.wepractice@hin.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

Adjustment disorder / Sleeping problems

Autism spectrum disorder / Developmental disorder

Relationship problems/ Sexual disorder and dysfunction

Eating disorder

Crisis / Conflicts / Difficulties in social behavior

Personality disorder

Psychosomatic disorder

Addictive disorder

Trauma

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*