Request for a telephone interview with Dr Jan Polak

Only for Health professionals who want to know more about the Acu-AnMo online training

Please fill in the form below,

so that we can agree on a day and an hour.

You will receive a confirmation if the time you wish is available

and you can then call me at 0033 562 66 77 88.

Please note: time of Paris

To make our interview as useful as possible to you, I would ask you to have

first read the course description carefully and watched the presentation video.

So it will be a pleasure to meet you soon,

Dr. Jan Polak

Name & first name

E-mail

Exact occupation (this is only for health practitioners)

Your telephone number

City & State

Country

Website (if you have one)

Time difference with France (Paris time)

I have read the description of the training and watched the videos

oui

I would like to have a telephone interview with Dr Jan Polak :

Say (from monday to friday)

French hour (Paris)

15 h

16 h

17 h

We will get back to you as soon as possible to confirm this time slot.

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Note : veuillez remplir les champs marqués d'un *.

Please note : if we do not respond quickly,

remember to check your spam box.