KÖ-Klinik Düsseldorf - Private clinic for cosmetic and plastic surgery

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KÖ-KLINIK GmbH
Königsallee 60 C
40212 Düsseldorf
Germany

Telephone:
+49 (0)211 - 8 65 35 0

Telefax:
+49 (0)211 - 8 65 35 37

info@koe-klinik.de

Name and address:

Mrs. Mr.

First name

Last name

Street

Post code, town

Available via telephone from o'clock until o'clock

E-Mail*

You are interested in a counselling session
and would prefer to be contacted via:

Email telephone letter

Your desired topic of consultation:

Breast enlargement
Breast lifting, breast reduction
Correction of inverted nipples
Gynaecomastia
Liposuction
Abdominal wall lifting
Perspiratory glands suction
Eyelid correction
Rhinoplasty
Ear correction
Face lifting
Wrinkle injection
Lip modelling

Please send me information brochures.

How have you become aware of the KÖ-Klinik?

Newspaper
Internet
Word-of-mouth recommendation
TV

Comments and enquiries:

Securitycode*

* fields marked with a star must be completed.

Mrs. Mr.
First name
Last name
Street
Post code, town
Available via telephone	from o'clock until o'clock
E-Mail*

You are interested in a counselling session and would prefer to be contacted via: Email telephone letter

Your desired topic of consultation:
Breast enlargement Breast lifting, breast reduction Correction of inverted nipples Gynaecomastia Liposuction Abdominal wall lifting Perspiratory glands suction	Eyelid correction Rhinoplasty Ear correction Face lifting Wrinkle injection Lip modelling
Please send me information brochures.

How have you become aware of the KÖ-Klinik?
Newspaper Internet Word-of-mouth recommendation TV

Comments and enquiries:

Securitycode*