Patient Profile

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Please fill out the questionnaire. Online registration allows you to save up to 20 minutes at the first visit to the Clinic. We appreciate your time!

Clinic:

Patient:

Gender:

Contact phone number and email address mail

Registration address:

Identity documents:

Do you have a legal representative?

(For patients under 18 and disabled citizens)

Don't forget to bring your passport!

By sending a request, you give consent to personal data processing