Schedule a consultation

We would be pleased to advise you personally and together we will make your switch to AOK NORDWEST perfect. We need your personal data to schedule a consultation.

My data

Salutation *

Title

First name *

Last name *

Date of birth *

Due to legal requirements, only persons over the age of 15 are permitted to change health insurance companies.

Address

Country *

Postcode *

City *

Street *

No. *

Additional address information

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Contact

Phone-/Mobile Number

It is not mandatory to mention your telephone or mobile phone number. However, this information will help us reach you quickly in case of any queries.

Email address *

Your email address is required for authentication. Once we receive your application, an email with a confirmation link is sent to the address provided by you.

Details of data protection

Data protection notice

This information is optional. However, you need to provide information in the fields marked with * so that we can forward your consultation request to the right person and contact you. You can rest assured that we will treat all information provided by you as confidential. Third parties or service providers commissioned by us may be the recipients of your data within the scope of legal obligations and powers of notification. General information on data processing and your rights can be found at aok.de/nw/datenschutzrechte. If you have any questions, please contact AOK NORDWEST, Kopenhagener Str. 1, 44269 Dortmund, kontakt@nw.aok.de or our Data Protection Officer at datenschutz@nw.aok.de.

Details of data use

Consent to data use

I consent to AOK NORDWEST processing and using my data in order to inform and advise me in the future about the services and products of AOK NORDWEST in a targeted manner by email, including within the scope of customer surveys. I can revoke this consent at any time with effect for the future - a call to the service number 0800 265 5000 is sufficient. You can only make this declaration of consent if you have reached the age of 15.

Yes, I agree.

* Mandatory field