FORM TO ACCESS THE TREATMENT

ACCESS TO TREATMENT AVAILABLE TO ELIMINATE HIV AIDS VIRUS

To access treatment and information of THE MUTAMBA MGU-T PROJECT, directly will be required to provide the following essential information detailed on the form for our records, then we will send the information concerning in reference to the cost, payment and the relevant documentation required, along replies questions about the full treatment, they found extensively detailed on this site.

After submitting the form, your data is stored and quote request or order will be placed in the consultation process, the response will be sent with the necessary information as soon as possible.

If you have any problems with the language in the answers, please forward the email to the support center or call center, to help you.

USEFUL RECOMMENDATIONS TO THE TIME OF REGISTRATION

Read the recommendations before registration.

Before sending your data in the form,  please to verify that these are correct, as your full name, last names, resort town, email addresses  and telephone numbers or if the phones requires some need to contact like international code, if is necessary.

In most cases it is easier and convenient to the company of shipping and international shipping, ship the treatment package to an address in a Central Post of the city or town of the applicant patient, than deliver to the address of the patient, if you have the direction of the Central Post of your locality or city, please detail it in the form section (Address for sending treatment), this to send directly the treatment to that address, we label us with your full name.

You can also contact the call center the new shipping address later if is necessary.

DATA OF THE APPLICANT OR PATIENT :

(Please put in the form correctly your email address).

Attention: The fields marked with * are mandatory.