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Thank you for visiting our web site To enable us to respond to you clearly and accurately and as quickly as possible, we recommend that you carefully fill in all fields of this form and send us photos (attach at the bottom of the form) of the parts of your body to be treated. These photos are absolutely essential to allow the surgeon to make a first accurate diagnosis.

Important : Fill in this form does not in any way commit you and all information contained therein remain fully confidential.
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jpg, jpeg, png et gif)

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