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Alta usuario Portal Paciente
Alta usuario Portal Paciente
General
Indique el email donde recibirá un código de INVITACIÓN gratuitamente en unos dos minutos, una vez rellene este formulario y nuestro sistema lo valide
Email
*
*
*
Mobile phone
*
*
Abbreviation
Mr.
Mrs.
Name
*
*
Patient name
*
*
Patient type
*
Cat
Dog
Equine
Bird
Fish
Hamster
Snake
Other
Address
*
Postal Code
*
City
*
Province
*
CONTACT PREFERENCES
Contact Method
*
Any
Email
Mail
Phone
SMS
WhatsApp
Contact by WhatsApp
Contact by WhatsApp
No
Contact by WhatsApp
Yes
Contact by Email
Contact by Email
No
Contact by Email
Yes
Contact by Phone
Contact by Phone
No
Contact by Phone
Yes
Contact by SMS
Contact by SMS
No
Contact by SMS
Yes
Contact by Mail
Contact by Mail
No
Contact by Mail
Yes
*
I accept the policy of conditions
*
I accept the policy of conditions
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Our Clients want to communicate with the Companies with a fast and efficient way:
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using their mobile phones
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