Full Name*

Phone Number (required) (enter the same number as given in the file)

Verify Code (required)

Reason Of Refund*
Treatment Not ProvidedAdvanced PaymentUnsatisfied With The ResultsChange In Treatment PlanOther

Method Of REFUND
I want the amount as an advance in my accountI accept to receive the refund in the form of chequeI accept to receive the refund via bank transfer

Disclaimer
The company does not hold any legal responsibility or financial liabilities that may result due to a wrong transfer as a result of the applicant providing inaccurate personal or financial information about his/her bank account.

Notes
Your application will be processed within 10-14 working days and you may be requested to be seen by a specialized doctor for medical report

Related Articles To The Re-Treatment
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Attachment

Comments

I hereby declare that I have discontinued my treatement in Maleen Consultant Center of my own free will and I hold all responsibility for my decision. I have no right to claim any material or moral rights for consequences of my decision.