We kindly asky ou to fill out the basic information. We will get in touch within 48 hours.
Code of diagnosis
Our doctors will go through your documentation and they will consider weather the proton treatment is applicable.
Thank you very much. By doing this you are helping other potential patients to get to know about us.
By filling in the contact from, I give my consent to the Proton Therapy Center Czech Ltd., Budinova 2437/1a, 180 00 Prague 8, ID: 26466791 (as the "Data Manager") for the processing of my personal data in the extent specified in this form in accordance with Act No. 101/2000 on the protection of personal data and amending certain laws, as amended (hereinafter referred to as "APPD"). The subject gives its consent for an indefinite period. The subject may withdraw its consent at any time via written or electronic form.
Nejpozději do dvou pracovních dnů Vás budeme kontaktovat telefonicky nebo na uvedeném e-mailu.
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