Dental Policlinic Dr. Gikić

New patients

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Information will be sent by e-mail if stated, or you will be contacted by a representative of Dental Policlinic Dr. Gikić by phone..

*Name:

*Surname:

*Date of birth (d/m/y):

*Sex M Ž

Country:

City:

Street & house nr.:

E-mail:

*Phone or cell phone:

*Appointment date:

Alternative appointment date:

Short description of the problem and questions:

Attachment - examples (supported formats: Ms Word, Adobe Acrobat (pdf)).

Attachment1

Attachment2

Airplane transfer offer Yes No

City transfer offer:

Accommodation offer Yes No

Other activities offer Yes No

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