In order to give you precise advice on your situation and your health, we would ask you to complete this questionnaire conscientiously and as completely and truthfully as possible. All diseases that have also been experienced and healed in the past should be noted.
Please, email your completed questionnaire to email@example.com or send it by fax 00420 234 770 295.
These websites belong to ISCARE a.s., with headquarter at Prague 9, Českomoravská 2510/19, ZIP code 190 00, Identification Number: 61858366, registered in the Commercial Register maintained by the Municipal Court in Prague, Section B, File No. 2703. The company ISCARE a.s. is a member of the group SynBiol, Inc., controlled by SynBiol, Inc., with headquarter in Prague 4, Pyšelská 2327/2, ZIP code 14900, Identification Number: 26014343, registered in the Commercial Register maintained by the Municipal Court in Prague, Section B, File No. 14742.