Fill in the form below to book an appointment


Name: *
Surname: *
Date of birth: *
Phone: *
E-mail:
* Mandatory If you enter a mobile phone number,
we can send you a reply by SMS

I want to book an appointment with dr. M. Tombesi

Enter the date and the preferred time

WARNING:
We schedule appointments for the afternoons only, on:
Tuesday, Wednesday and Friday
NOT BEFORE PUBLIC HOLYDAYS.
Online requests of appointments need one working day for arrangement.

PRINT OUT A COPY BEFORE SENDING THE FORM

 

This form will be sent by e-mail to the doctor's office.
E-mail over the Internet is not a secure medium and privacy cannot be assured.
If you don't feel comfortable with this, please call us or come to the office.