As part of your forthcoming treatment we have prepared the following questionnaire, which serves to facilitate the communication between you and our physician. Please complete the questionnaire by filling out all the required data. Do not hurry, take your time. The information in the questionnaire is very important and will help the physician with designing the best treatment option for you. The questionnaire also includes your identification data, which is required to draft the Application for Treatment.
This site is secured via encryption and an SSL certificate, which provides communication between you and the data server. The data is stored only in the database of Reprofit International Ltd. The data is treated sensitively, we protect it from misuse and never provide it to a third party.
Thank you for your assistance, we are wishing you a successful treatment.