Enquiry – NeuroAiD for Traumatic Brain Injury

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Make the most out of your precious recovery

This form allows the NeuroAiD™ product specialists to better understand your specific case in order to give you an appropriate answer.
Our well trained and dedicated staff will get back to you within 1-2 business days . All particulars remain strictly confidential.
Before submitting your enquiry, please note that your doctor is in the best position to advise you on the ideal treatment for your individual situation. In case of doubt, always seek advice from your doctor.

(Please note that fields with * are mandatory)

Step 1 of 2

When did the brain injury occur?*
Details about Traumatic Brain Injury (TBI)
Who suffered from TBI?*
Patient's age
Patient's name
Patient's surname
What caused the TBI?
How severe was the TBI?
What disabilities did it cause?

Contact Information
First name*
Last name*
Email*
Enter Email Confirm Email
Country*
Home Phone*
Mobile Phone
What questions do you have about NeuroAiD II?
I would like to subscribe to the NeuroAiD newsletter*
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Name
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By submitting this form, I agree to the privacy policy and understand that I will be contacted by Moleac & NeuroAiD team via the contact methods submitted

Make the most out of your precious recovery

Step 1 of 2

Details about Traumatic Brain Injury (TBI)

Contact Information