contact form

Your email address *

If you wish to get in touch, I will get in touch immediately. (Mandatory fields are only the e-mail address, the reason for contacting and the data protection consent at the end of the form.) I look forward to hearing from you!

Desired way of contacting: *

Please contact me by phone to clarify my request. Please contact me by e-mail to clarify my request.

Please place a check mark if you want to publish an advertisement:

I want to publish a free ad to the provider portal

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Contact information:

Name:

Surname:

T.:

Address information:

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There is room for additions of any kind (e.g. for a general comment or other request)

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I agree to the processing of the entered data as well as the data protection declaration (see under https://www.bergische-waldstreuner.de/Datenschutzerklaerung). *

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