Consultation with an internist, pediatrician or family doctor

Specialist

Clear

Name and surname *

PESEL number *

Phone number *

Address *

Zip code *

City *

Reason for consultation / symptoms *

Select the day you want to use the teleconsultation

Date *

You can attach test results or a photo of your symptoms.

Attachment

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I declare that the patient's condition, which is the reason for the consultation, does not pose a threat to his health or life. *

SKU: N/A Categories: Basic, E-services