Contact us quickly and simply

Contact us quickly and simply online using the contact form, write an email directly to info@praxis-dostal.de or send us a fax or a letter. We try to answer your requests immediately.






1. Information about yourself

Your first name *

Your family name *

Patient status *

Your E-Mail-Address *

Your date of birth *

Your telephone number

2. Your request to us

Subject

Your comments *

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I agree that my details from the contact form will be collected and processed to answer my request. The data will be deleted after the processing of your request. Note: You can revoke your consent at any time for the future by e-mail to info@praxis-dostal.de . Detailed information on handling user data can be found in our privacy policy.
(You will not be able to submit the form without your consent.)