Create objednání do ordinace

PATIENT

*
how can we contact you if needed?
we do NOT send any automatic confirmation
fill in your email address @
a confirmation message will be sent to this email address

APPOINTMENT

write another reason or clarification in the comment section below

APPOINTMENT TIME

you can choose from the available dates
dates to choose from are only visible when:
  • you have entered the Reason for the visit
  • you have selected Week
  • at least some dates in the selected week are free

CONSENT

By submitting the form, you consent to the processing of personal data contained in the form.
In accordance with the GDPR, this data will be used exclusively for the purposes of planning visits to this office and will not be provided to third parties.

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by Dr. Radut