IOM International Organization for Migration IOM Internationale Organisation für Migration ZIRF- Counselling Form for Individual Enquiries 1. Enquiring agency data Enquiring agency Name of advisor Contact information for enquiring agency Federal state in which enquiring agency is located (important) 2. Personal data of person on whose behalf the enquiry is conducted Age Gender Ethnic origin Country of origin Destination Final destination (city, village) Occupation Professional qualifications 38 M Kosovo Kosovo Priština 3. Sphere: Health Care 4. Individual Enquiry: Background Information: The man is suffering from depressions and a posttraumatic stress disorder (PTSD). Enquiry: 1.) Is adequate treatment for the patient currently available (If yes, please give information and contact details of specialists/doctors)? - PTSD: - depressions: 2.) Are the following drugs or their active agents available? If yes, please give the official trade name, price per package and number of tablets inside: - Paroxetin 20 (active agent: paroxetine): - Seroquel 50 (active agent: quetiapine): IOM – Vertretung für Deutschland: Wallstraße 69 • D-10179 Berlin • Deutschland • Fax: +49.30.278 778 99 IOM - Zweigstelle in Nürnberg: Postfach 40 01 59 • D-90206 Nürnberg • Frankenstraße 210 • D-90461 Nürnberg • Deutschland • Fax: +49.911.4300 260 Telefonzentrale IOM Deutschland: +49.911.43000 E-Mail: IOM-Germany@iom.int • Internet: http://www.iom.int/germany Seite 1 IOM International Organization for Migration IOM Internationale Organisation für Migration 3.) The man is financially needy. Are the mentioned drugs available free of charge? Answer: 1.) The treatment for PTSD and minor depressions is available only in private clinics. Private Clinic “Klinika Aura” Dr.Jusuf Ulaj and Dr. Afrim Blyta Tel. +381 (0) 38 53 00 00 2.) The drugs are available: - Paroxetin 20 (active agent: paroxetine): GSK / 6€ / 20 tablets - Seroquel 50 (active agent: quetiapine): GSK / 20€ / 20 tablets 3.) Mentioned drugs are not available free of charge. Case ID (IOM): ZC204/12.12.2013 Seite 2