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Select your appointment - Felipe Fernandes Patury

* Addresses :

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* Type of appointment:

Adult (1)

Adulte (45 minutes)

Children 9 - 12 years (1)

Enfant 9 - 12 ans (45 minutes)

Teenager 13 - 16 years (1)

Adolescent 13 - 16 ans (45 minutes)

Teenager 17+ years (1)

Adolescents 17 ans et + (45 minutes)

Couple (1)

Couple (50 minutes)

Family (1)

Famille (50 minutes)

Home appointment (1)

RDV à domicile (45 minutes)

Online consultation (1)

Consultation en ligne (45 minutes)

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* Civility

* Name:

* First name:

* Last name:

* First Name:

* Child's civility:

* Date of birth:

* First name partner:

* Name partner:

family composition

* Name:

* First name:

Name:

First name:

Name:

First name:

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I accept the Terms and Conditions

I certify that the data provided are correct and I agree to notify the psychologist at the latest 48 hours before the appointment if I will not be present. Otherwise the consultation will be due.