×
Feil kommando.
Polski
English
Norsk
Русский
Український
Bestill time
Du registrerer deg til:
FizjoHome | Chojnice | Młodzieżowa 25 / 8
Velg spesialist
Velg spesialist
Velg kontor
Velg
Valgt tidspunkt
bytt
Angi pasientopplysninger
Fornavn
Etternavn
Telefon
+48
+48 Poland
+93 Afghanistan
+355 Albania
+213 Algeria
+376 Andorra
+244 Angola
+1264 Anguilla
+672 Antarctica
+1268 Antigua and Barbuda
+966 Saudi Arabia
+54 Argentina
+374 Armenia
+297 Aruba
+61 Australia
+43 Austria
+994 Azerbaijan
+1242 Bahamas
+973 Bahrain
+880 Bangladesh
+1246 Barbados
+32 Belgium
+501 Belize
+229 Benin
+1441 Bermuda
+975 Bhutan
+375 Belarus
+591 Bolivia
+599 Bonaire, Sint Eustatius and Saba
+387 Bosnia and Herzegovina
+267 Botswana
+55 Brazil
+673 Brunei
+246 British Indian Ocean Territory
+1284 British Virgin Islands
+1284 British Virgin Islands
+359 Bulgaria
+226 Burkina Faso
+257 Burundi
+56 Chile
+86 China
+385 Croatia
+599 Curaçao
+357 Cyprus
+235 Chad
+420 Czech Republic
+0 United States Minor Outlying Islands
+45 Denmark
+243 Democratic Republic of the Congo
+1767 Dominica
+1809 Dominican Republic
+253 Djibouti
+20 Egypt
+593 Ecuador
+0 El Salvador
+291 Eritrea
+372 Estonia
+251 Ethiopia
+500 Falklands
+679 Fiji
+63 Philippines
+358 Finland
+33 France
+0 French Southern and Antarctic Lands
+241 Gabon
+220 Gambia
+593 South Georgia and the South Sandwich Islands
+233 Ghana
+350 Gibraltar
+30 Greece
+1473 Grenada
+299 Greenland
+995 Georgia
+1671 Guam
+502 Guatemala
+441481 Guernsey
+592 Guyana
+594 French Guiana
+590 Guadeloupe
+240 Guinea-Bissau
+240 Equatorial Guinea
+509 Haiti
+34 Spain
+31 Netherlands
+504 Honduras
+852 Hong Kong
+91 India
+62 Indonesia
+964 Iraq
+98 Iran
+353 Ireland
+354 Iceland
+972 Israel
+1876 Jamaica
+81 Japan
+44 Jersey
+962 Jordan
+1345 Cayman Islands
+855 Cambodia
+237 Cameroon
+1 Canada
+974 Qatar
+7 Kazakhstan
+254 Kenya
+996 Kyrgyzstan
+686 Kiribati
+57 Colombia
+269 Comoros
+850 North Korea
+82 South Korea
+506 Costa Rica
+268 Kingdom of Swaziland
+53 Cuba
+965 Kuwait
+856 Laos
+961 Lebanon
+266 Lesotho
+231 Liberia
+218 Libya
+423 Lichtensztein
+370 Lithuania
+352 Luxembourg
+371 Latvia
+389 Macedonia
+261 Madagascar
+853 Macau
+265 Malawi
+960 Maldives
+60 Malaysia
+223 Mali
+356 Malta
+1670 Northern Mariana Islands
+0 Morocco
+596 Martinique
+222 Mauritania
+230 Mauritius
+262 Mayotte
+52 Mexico
+691 Micronesia
+373 Moldova
+377 Monaco
+976 Mongolia
+382 Montenegro
+1664 Montserrat
+258 Mozambique
+95 Myanmar
+264 Namibia
+674 Nauru
+977 Nepal
+49 Germany
+227 Niger
+234 Nigeria
+505 Nicaragua
+683 Niue
+47 Norway
+675 New Guinea
+687 New Caledonia
+64 New Zealand
+968 Oman
+92 Pakistan
+680 Palau
+970 Palestine
+507 Panama
+595 Paraguay
+51 Peru
+0 Pitcairn
+689 French Polynesia
+1787 Puerto Rico
+351 Portugal
+224 Republic of Guinea
+27 South Africa Republic
+236 Central African Republic
+225 Republic of Côte d'Ivoire
+238 Cape Verde
+242 Republic of the Congo
+262 Reunion
+7 Russia
+40 Romania
+250 Rwanda
+212 Western Sahara
+1869 Saint Kitts
+1758 Saint Lucia
+1784 Saint Vincent and the Grenadines
+590 Saint-Barthélemy
+508 Saint-Pierre and Miquelon
+684 Samoa
+1684 American Samoa
+378 San Marino
+239 Sao Tome and Principe
+221 Senegal
+381 Serbia
+248 Seychelles
+232 Sierra Leone
+65 Singapore
+1721 Sint Maarten
+421 Slovakia
+386 Slovenia
+252 Somalia
+94 Sri Lanka
+0 St. Martin
+1 United States
+249 Sudan
+211 South Sudan
+597 Suriname
+47 Svalbard and Jan Mayen
+290 Saint Helena
+963 Syria
+41 Switzerland
+46 Sweden
+992 Tajikistan
+66 Thailand
+886 Taiwan
+255 Tanzania
+670 East Timor
+228 Togo
+690 Tokelau
+616 Tonga
+1868 Trinidad and Tobago
+216 Tunisia
+90 Turkey
+993 Turkmenistan
+688 Tuvalu
+256 Uganda
+380 Ukraine
+598 Uruguay
+7 Uzbekistan
+678 Vanuatu
+681 Wallis and Futuna
+0 Vatican
+36 Hungary
+58 Venezuela
+44 United Kingdom
+84 Vietnam
+39 Italy
+61 Christmas Island
+441624 Isle of Man
+6723 Norfolk Island
+358 Landskapet Åland
+0 Cook Islands
+1340 U.S. Virgin Islands
+0 Heard Island and McDonald Islands
+61891 Cocos Islands
+692 Marshal Islands
+0 Faroe Islands
+677 Solomon Islands
+1649 Turks and Caicos Islands
+967 Yemen
+260 Zambia
+263 Zimbabwe
+971 United Arab Emirates
E-postadresse
Personnummer
Postnummer
By
Gate
Husnummer
Nummer på lokalet
Melding til spesialist - beskrivelse av helseproblemet
Chojnice, dn. …………….
Deklaracja zgody na przetwarzanie danych osobowych
Dane pacjenta:
Nazwisko ……………………………. Imię ………………………..
PESEL ……………………………….
Zakres danych:
nr telefonu:……………….…...................
adres e-mail:…………………………….
Ja niżej podpisany/a wyrażam zgodnie z art. 7 ust. 2 Rozporządzenia Parlamentu Europejskiego i Rady UE 2016/679 z 27 kwietnia 2016 r. wyraźną i dobrowolną zgodę na przetwarzanie i zbieranie moich danych osobowych przez
FizjoHome Indywidualna Praktyka Fizjoterapeutyczna Katarzyna Śliwicka ul. Młodzieżowa 25/8 89-600 Chojnice w
celu:
zapewnienia ciagłości świadczenia usług fizjoterapeutycznych
zarządzania udzielaniem usług fizjoterapeutycznych
……………………..
czytelny podpis pacjenta
vis mer
Jeg godtar bestemmelsene
reglementet
Registrer deg
Jeg bestiller med betalingsplikt
Vi sender deg en SMS med en bekreftelseskode til telefonnummeret du har oppgitt.
Send på nytt
Skriv inn den mottatte SMS-koden
Bekreft besøket ditt
Det oppgitte telefonnummeret
er feil?
Endre antall
Regelverk og personvernerklæring
·
FizjoHome | Chojnice | Młodzieżowa 25 / 8