Free choice of hospital (Comunidad de Madrid and CCAA that allow it)

What you need to have to hand

1. Tarjeta Sanitaria Individual of your CCAA (in Madrid, SERMAS).
2. DNI/NIE in date.
3. Volante de derivación from your GP for the specialty, naming the hospital you want.
4. Proof of appointment if you were already assigned to another hospital (they will ask for it to process the change).
5. Cl@ve, DNIe or certificado digital to book online and access your Carpeta de Salud.

Documentation

• TSI and DNI/NIE: basic ID.
• Volante/interconsulta with specialty and selected centre. Without this, the hospital won't schedule you.
• Proof of appointment/waiting list if you come from another hospital.
• Authorisation and DNIs if you act on behalf of someone else.
• Libro de familia/tutela for minors.

Step by step

1. See which hospitals you can pick: open the free choice guide of Madrid: https://www.comunidad.madrid/servicios/salud/libre-eleccion-sanitaria and the hospital directory: https://www.comunidad.madrid/servicios/salud/hospitales. Note the exact centre name.
2. Book an appointment with your GP at https://www.comunidad.madrid/servicios/salud/cita-atencion-primaria (identify with Cl@ve, DNIe or SMS). If the site fails, call your centre.
3. In the appointment, ask for the volante to the chosen hospital. Say it clearly: 'quiero derivación al Hospital X por libre elección'. Ask for a copy or later download the PDF from your Carpeta de Salud (https://www.comunidad.madrid/servicios/salud/carpeta-salud).
4. If you already had an assigned hospital, contact the Unidad de Atención al Paciente of the destination hospital (phone/email on its directory page) and request the change, attaching DNI, TSI and the volante. They will give you instructions for the appointment.
5. Confirm the appointment. If within 7–10 días hábiles they don't call you, chase them: call the citación number of the new hospital with the referral number ready.

Time-saving tips

1. Decide the hospital in advance: avoid back-and-forth checking options. The Madrid hospital finder shows services and phone numbers.
2. Get the volante naming the exact centre: if the volante is generic, they'll bounce it back and you'll have to redo it.
3. Download the volante PDF from Carpeta de Salud and save it. It helps push the change with the Unidad de Atención al Paciente.
4. If you change while on a waiting list, explicitly ask whether you keep the inclusion date. That avoids surprises.
5. Browser: Carpeta de Salud usually works better in Chrome. If Cl@ve acts up, use DNIe.

Common mistakes to avoid

1. Trying to change without a referral: without an active volante there is no scheduling at the new hospital.
2. Picking a hospital that lacks the specialty: some centres don't have certain units. Check the cartera de servicios first.
3. Thinking it applies to emergencies: free choice is for scheduled processes. In emergencies you get treated where you're taken.
4. Not telling them if you're already pre-op: changing too late can delay you by weeks. Coordinate with the Unidad de Atención al Paciente.
5. Assuming transport is covered for preference: if you pick a far hospital just because you prefer it, normally you pay travel costs.