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Book a session with a psychologist

Fill in the form below. Our staff will confirm your booking and send your queue number to your WhatsApp.

Service *

Session type

Visit date *

Psychologist schedule *

Full name (as on ID card) *

Gender *

Place of birth

Date of birth *

ID type

ID number

WhatsApp number *

Address

City

Parent/guardian name

Relationship

Guardian phone

I consent to the processing of my personal and health data for psychological services (Law No. 27 of 2022 on Personal Data Protection). *

The information I provided is correct. I will bring my ID card and sign the general consent form at the clinic on arrival. *

Your booking is not final until our staff confirms it via WhatsApp.

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