MAKE NOW YOUR

FIRST APPOINTMENT

Clínica Rinològica Maria Colomé

At the Rinològica Maria Colomé Clinic we look after your nose health.

In this first visit we will listen to you in detail to understand what your problem is – aesthetic or functional – and we will explain how we can help you.

We have specialized technology to make an accurate diagnosis and give you the answer you need, to improve your life quality.

We like our patients to feel comfortable, so we ask you to fill in the following form and we will contact you to arrange a first appointment.

What is the reason for your inquiry?

I would like make a small change to my noseI snore a lot and/or I have apneasI do not breathe wellI suffer from rhinitis and/or sinusitisI have polypsI have lost smellOthers

Do you want to briefly explain the reason for your visit?

Name

Surname

How do you prefer that we contact you to give you an appointment?

E-mail:

Phone:

I have read and accepted the privacy policy.

Thank you very much for your trust and see you soon.