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FRNLEN

>>Request of modification or cancellation of appointment

AppointmentIf you have to cancel your appointment please do so at least 24 hours in advance so that another patient may benefit from the appointment time. Otherwise, cancellation fees will apply.

It is also possible to ask for an appointment online via this specific page.

Please fill in all fields marked with a star *.

Not to fill in !

Last name *
First name *
Birthdate (dd/mm/yyyy) *
Telephone (preferably GSM) *

Current appointment is scheduled on at h in *

Name of the doctor / consultant

Your request * :
Change of date
Cancellation

Comments :

>>Appointment request form / Electronic list of consultations and consultants.