Signature:________________________ Date: ______ / ______ / ________ Place: |
Please note By law only Medi*al doctors are allowed to diagnose and do
treatment. Also registered pharmaceutical Medi*ines recommended by Medi*al
doctors must be used. Please do not contact us if you have not already tried
orthodox way of treatment. Do not discontinue your medication. We may suggest
special natural diet or complementary supplements that we suggest you check
with your Medi*al doctor before use.