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Doha, Qatar

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Clinic Information Form

Please take your time and answer ALL of the questions. Thanks

Clinic Info

Medical Center Name:

Clinic Name:

Email:

Tel:

Clinic Description: (Give information about the clinic)

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List of Medical Services:










More:

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Clinic Doctors Name:





More:

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Clinic Insurance Companies:










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Working Hours:

Full day hours

Please tick the dates that apply to your clinic.

From:
To:

&

From:
To:

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Half day hours

Please tick the dates that apply to your clinic.

From:
To:

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Official links & files

Clinic Video link:

(if available)

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Cinic Photos

Please attach high resolution copy of your photo here only .jpg or .png accepted, max: 4mb



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Other Documents?

You may share with us any additional files here only zip, rar, pdf, doc, docx, ppt, pptx files accepted, max: 12mb

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