Appointment

If you want to make an appointment with any of our paediatricians or paediatric specialists, please leave us your information and we’ll get in touch with you as soon as we can.If you do not know the professional’s name, please indicate their specialisation or fill in the “Notes” field with an explanation of the reason for the appointment. Sending this form entails acceptance of our Privacy Policy.

CHILD’S FULL NAME (*)

E-mail (*)

SUBJECT

SPECIALIST

SPECIALISATION

TIME PREFERENCES:

CONTACT TELEPHONE(S) (*)

NOTES

I have read and accept the Data Protection clause

You will find us at...