Appointment

You can enter the complete form, with the required data,which you can fill in the fields provided. Entry into all fields is optional. Please enter data with as many data imprints as possible.

All entered data will be used only for the purpose of THERAPY. The confidentiality of the data is guaranteed by the Fizio Center MANUS.

After the completed and sent form, the ambulance staff will contact you by phone and / or e-mail to inform you whether the desired appointment is free and possibly arrange with you a new term.