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Especialistas/Specialist
Por favor, complete este formulario y pronto nos pondremos en contacto con usted/Please complete this form and we will contact you soon
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Ciudad/City
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Puerto Vallarta
Merida
Guadalajara
Chapala
Playa del Carmen
Cozumel
CDMX
Puebla
Morelia
San Jose del Cabo
San Luis Potosi
Mazatlan
Culiacan
Cuernavaca
Selecciona tu especialista/Select your specilaist
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Choose
Neumólogo/Pulmonologist
Geriatra/Geriatrician
Internista/Internist
Cardiólogo/Cadiologist
Terapeuta fisico/Physical Therapist
Cirujano/Surgeon
Traumatólogo/Othopedic Surgeon
Ginecólogo/Gynecologist
Gastroenterólogo/Gastroenterologist
Cirujano Oncólogo/Oncologic Surgeon
Pediatra/Pediatrician
Oftalmólogo/Ophtalmologist
Otorrinolaringólogo/ENT Doctor
Anestesiólogo (manejo de dolor)/Anesthesiologist (pain managment)
Medicina del deporte/Sports medicine
Otro (por favor indíquelo en "Comentarios adicionales")/Other (please indicate in "Additional Comments")
Nombre del paciente/Patient Name
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Your answer
Fecha de nacimiento/Date of birth
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Your answer
Whatsapp
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Your answer
E-mail
Your answer
Motivo de consulta/Reason of consultation
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Your answer
Comentarios adicionales/Additional comments
Your answer
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