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Registration for the video consultation

If you would like to make an appointment with us for a video consultation, we need the information below from you.
We will then contact you to arrange an appointment.

For the video consultation, you can either use a mobile phone with a camera or a laptop/PC with a camera and loudspeaker.

Data protection*

I have the  Data protection  noted. I agree that my contact details and queries will be stored permanently. You can revoke your consent at any time for the future by sending an email to

* You cannot use the form without this information. Please send us an email.

Thank you for your message!
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