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Appointment cancellation
Welcome to appointment cancellation page. If you want to cancel your appointment, please fill in the personal details and necessary information below. * These fields are necessary to fill in.
Name and surname *
E-mail
Date of Birth
Appointment Date *
Doctor /specialization *
Additional Information *
Patient Card
Corporate clients
Individual clients
Clinic's address *
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Please contact me to arrange a new appointment
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Additional comments:
By accepting this form you hereby agree to the processing of your personal data for the marketing purposes of LUX MED, in accordance with the Personal Data Protection Act (Journal of Laws No 133, item 883).
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