Order form

Request an invitation Contract prepayment

You could request an invoice for 100% prepayment of contract with Dr. Bubucea’s Office.

DETAILS FOR THE CONTRACT

First and Surname (like in the passport)

Passport Number

Date of Birth

Date of Visit to the Clinic

Expected Date of Delivery

Phone number

E-mail address

Home address

I have read and accepted the terms and conditions of contract prepayment

The contract is non-refundable except in case the patient was rejected a US visa. In case of visa rejection, the office returns the funds to the same bank account from which the prepayment had been made upon presentation of supporting documents (visa rejection stamp in the passport, letter from US Embassy) except the cost of the invitation letter (USD 500) and commission (USD 200).

If you had prepaid USD 500, please click 5000. Otherwise, please click 5500

Have questions? Please contact us

DETAILS FOR THE CONTRACT

YOUR MESSAGE IS SUCCESSFULLY SENT!