Reservation ContactsFirst name *Last name *BirthdateEmail *PhoneHow do I contact you back?EmailPhonePlace of therapyPractice in KfelyAt your addressThe price for therapy at your address is increased by 7 CZK / kmAddressAddressApartment, door numberCityZIP CodeAnamnesisThe anamnesis data is not mandatory to fill. It only serves to facilitate quicker diagnosis and overview of the patientThe pain areaStage of painAcute (up to 1 month)Subacute (3 - 6 months)Chronic (6 and more months)HeightCurrent weightWeight 6 months agoWeight change in 6 monthsKgWeight change in 6 monthsIncreaseWeight change in 6 monthsNo changeWeight change in 6 monthsDecreaseUndergoed imaging examinationsRTGCTMRICurrent therapyPhysical activitiesCurrent conditionExcellentGoodBadFluctuatingInjuriesOperationMedicinesFindingsDrag and Drop (or) Choose FilesIf you have medical documentation for the last 6 months, you can upload it here. Just take a picture or scan. If you are unable to upload, bring your documents with you to therapy.Additional InformationProfessionUrologyGynecologyPrivacy policyGDPR *By checking the box, you agree to the processing of personal data. These are used only for the purpose of ordering a gift voucher and communication. Here you can view the privacy policy and terms and conditions.Send an orderPlease do not fill in this field.
Reactive TherapyReactive Therapy