Travel the world.


A STAMARIL Center
John D. Wilson, M.D.
1200 Hilyard St., Ste. 560
Eugene, Oregon 97401 USA
541.343.6028
fax 541.485.7702
www.TravelClinicOregon.com

 

Please fill out and submit the following form. You will be contacted by e-mail to discuss your options.

Name:
Phone:
City in which you live now:
E-mail address:
Date of departure:
Duration of trip:
Non U.S. countries you will visit:
Names and birthdates of travelers:
Have you been a patient of Dr. Wilson before?
Did someone refer you to us?  Who was it?
Comments:
 
 

 

   Please enter the number to the left.

     

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  John D. Wilson, M.D. 1999-2017; Last Update 7/22/2017