Surgical appointment

To schedule a urological surgical procedure – such as suburethral sling placement, bladder polyp resection, endoscopic surgery or sacral root neuromodulation – please complete this form to arrange a pre-operative appointment with Dr. Peyrat.

Form to fill in

First name

Name

Date of birth

Phone

Problem / Need

Are you diabetic?

Are you a smoker?

Is this a second operation?

Do you see this as a special moment in the process?

Notes / Comments

If you’d like to call us directly, or if you’d like more information before making your request, you can contact us by phone or e-mail.

Phone

01 42 68 83 30

Email

contact@peyrat-urologie.fr

Website

www.peyrat-urologie.fr

Address

82 Boulevard de Courcelles,
75017 Paris