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Vardas pavardė Required Asmens kodas Required 🔒 Stored encrypted; only used to generate your draft. Deklaruotas adresas Required ⟦lt.field.phone⟧ Optional ⟦lt.field.email⟧ Optional ⟦lt.field.assessment_type⟧ Required ⟦lt.help.assessment_type⟧ ⟦lt.field.medical_institution⟧ Required ⟦lt.help.medical_institution⟧ 🔒 Stored encrypted; only used to generate your draft. Gydantis gydytojas / sveikatos priežiūros įstaiga Required 🔒 Stored encrypted; only used to generate your draft. ⟦lt.field.gkk_referral⟧ Required ⟦lt.help.gkk_referral⟧ 🔒 Stored encrypted; only used to generate your draft. ⟦lt.field.gkk_referral_date⟧ Optional Format: DD/MM/YYYY 🔒 Stored encrypted; only used to generate your draft. Pagrindinė diagnozė (TLK kodas, jei žinomas) Required ⟦lt.help.primary_diagnosis⟧ 🔒 Stored encrypted; only used to generate your draft. ⟦lt.field.secondary_diagnosis⟧ Optional 🔒 Stored encrypted; only used to generate your draft. ⟦lt.field.illness_onset⟧ Optional Format: DD/MM/YYYY 🔒 Stored encrypted; only used to generate your draft. ⟦lt.field.requires_care⟧ Required 🔒 Stored encrypted; only used to generate your draft. ⟦lt.field.has_prior_pazyma⟧ Required ⟦lt.field.prior_dlv_percent⟧ Optional 🔒 Stored encrypted; only used to generate your draft. Šiuo metu dirbu Required Darbdavio pavadinimas Optional Dirbau užsienyje Required ⟦lt.field.forward_to_sodra⟧ Required ⟦lt.help.forward_to_sodra⟧

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