Contact form - 👉 CM Luxmed Lublin

*fields required to be completed

Updated information on the processing of personal data is contained in the document Rules for the Processing of Personal Data at CM Luxmed

The rules regarding the processing of data on Luxmed websites are set out in our Privacy Policy

Name *:
Name *:
Company name:
Select the form of contact:	- e-mail - mailing address
Street *:
House number *:
Premises number:
Zip Code *:
Locality *:
Email *:
Contact Phone:
Order number online / payment *:
Select the facility, where the service was provided or was to be provided *:
Content of application *:
If the application relates to treatment undertaken at Luxmed Medical Center and continued outside the facility, a copy of medical records (including test results) from treatment outside Luxmed Medical Center facilities must be attached to the application.
Appendix:
Appendix:
Appendix:
Appendix:
I accept the rules of complaint