Please read our PRIVACY POLICY, which explains why and how we handle the Information you choose to share with us
AVERAGE TIME TO COMPLETION: 10 MINUTES
PLEASE NOTE THAT ALL FIELDS MARKED WITH AN ASTERISK (*) ARE REQUIRED.
WHY DO I HAVE TO SHARE THIS INFORMATION?
We strive to provide you with the best care, and the information you share with us is important so we can offer you a personalized attention both online and in person, that way we can use our time more effectively in the exam room.
The information contained in the Unique Declaration Form includes sensitive personal data that is treated as confidential in accordance with the provisions of the applicable regulations.
Do you need assistance? Please call us M-F 8am-5pm Central Time at +52 55 8817 3754