Medicine statement travel Drs. An van Veen (Performance code 24200, AGB code: 84021556, AGB clinic: 90064562)

Name: Medicine statement travel Drs. An van Veen (Performance code 24200, AGB code: 84021556, AGB clinic: 90064562)
SKU: MED100
Price: 19.00 EUR
Availability: InStock

€ 19,00

Performance code 24200, AGB code: 84021556, AGB clinic: 90064562

Requesting repeat prescription

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Name

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RECEPTIONS

I have had a consultation at BeterKliniek for the past six months?

Yes

No
If you have not had a consultation in the past year, you will be charged for a consultation if you continue with this form. You may still schedule the consultation the next month at no charge

I agree to pay €19 for the repeat prescription

Yes

No

Nothing has changed in my health condition since the last prescription?

That is correct

That is not correct

Based on the information you provided, you cannot request a repeat prescription. Please contact us during the free patient consultation hour: 040-7117337

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Number

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Medicine

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Dosage

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Number

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Unit

Medicine

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Dosage

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Number

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Note

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Medication statement trip Drs. An van Veen (Performance code 24200, AGB code: 84021556, AGB clinic: 90064562) number

Article number: MED100 Category: No category

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Medicine statement travel Drs. An van Veen (Performance code 24200, AGB code: 84021556, AGB clinic: 90064562)

Requesting repeat prescription

RECEPTIONS

DOE EEN DNA-TEST!

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