Country (*)
City (*)
First name (*)
Last name (*)
Phone (*)
E-mail (*)
Date of Birth (*) dd.mm.yyyy
Choose a rehabilitation program (*) 3-day body detoxification program no massages3-day body detoxification programIntensive 6-day13-day rehabilitation programA 20-day rehabilitation programA 27-day rehabilitation programA 60-day rehabilitation programA 90-day rehabilitation programA 180-day rehabilitation programA 365-day rehabilitation program
Diagnosis (*)
Date of arrival (*) dd.mm.yyyy
Date of departure (*) dd.mm.yyyy
Three meals a day (*) YesNo
Accommodation (*) StandardLUX
Additional info
I agree to have my personal data processed (*) I, hereby, give my consent to the collection and processing of my personal data in accordance with the EU General Data Protection Regulation (GDPR) in order to respond to my inquiry. I acknowledge that providing my personal data is voluntary, but necessary in order to receive information covered by the consent or to answer the questions. The data will be processed on the basis of art. 6 (1)(a) GDPR. I have been informed that I have the right to access my data, the possibility of correcting it, requesting discontinuation of its processing. The Administrator of personal data is the Academy of Regenerative Medicine, Plac Dworcowy 2G, 58-160 Swiebodzice, Poland.
Aleksander Haretski
Tel., Viber, WhatsApp: +48 609 371 999
Our website www.medycynaludowa.com Our shop shop.medycynaludowa.com Our movies www.youtube.com/AliaksandrHaretski
The Academy of Regenerative Medicine Plac Dworcowy 2G, 58-160 Świebodzice NIP 8842544905
Email: [email protected]
Username or email address *
Password *
Remember me
Lost your password?