I hereby declare I have not provided a false declaration of health (thus accepting to be disenrolled if proven otherwise)
Read the following information carefully and send your consent before sending the form.
. By submitting this form I agree to hire William Hope´s servicies
. I understand and agree to pay the fee. This fee corresponds to the medical assistance that starts and ends at the dates pointed out in this form. Click here to download the form.
. William Hope´s services in greater detail are available here.
. For any questions or queries regarding the service, I must contact with Fernando Cerccardi (Fernando_ceccardi@whope.com.ar) before accepting the terms and conditions.