Request service

For urgent matters please contact Gert Manshoven by telephone on Tel: +32 (0)54 51 54 53 – fax +32 (0)54 50 20 28 or email: gmh@lasermedico.be

Please direct complaints to Geert De Campeneere (gdc@lasermedico.be or +32 (0)475 31 96 22) or Gert Manshoven (gmh@lasermedico.be or +32 (0)54 51 54 53)

The form below can also be used to request a service or service intervention.
 

Title *

Choose a title Mr Ms

Last name *

First name *

Company *

Profile *

Choose a profile Acupuncturists Dermatologists Fitness profiles General practitioners Physiotherapists Physiotherapy specialists Plastic surgeons Sports doctors Wellness profiles

Street *

Number *

Box

Zip *

Location *

Country *

Phone *

Fax

E-mail *

Your message*: 

I wish to subscribe to the newsletter of Lasermedico

(*) Required fields

---

Send

---