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11A bd Joseph II
L-1840 Luxembourg
(+352) 27 40 18 40
pré-opératoire
être rappelé(e)
DEMANDER UN RENDEZ-VOUS
THANK YOU.
WE WILL CONTACT YOU TO PROPOSE AN APPOINTMENT DATE.
Please complete the form below and send it back to us by email (contact@centremonterey.lu)
(you can also print it out and bring it back the day of your consultation)
1) What is your first and last name?
2) What is your job ?
3) Do you have any allergies?
4) Do you have a general illness?
5) Do you have any eye disease?
6) Do you wear contact lenses?
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