Please let us know your name.
Please let us know your firstname.
Please let us know your email address.
Please let us know your message.
Please validate the consent in order to submit your request

To know and exercise your rights, especially for withdrawing your consent of the use of your personal data collected by this form, please consult our privacy policy or use this form to delete your personal information.

CRACMO reference centre

Hôpital Jeanne de Flandre
Avenue Eugène Avinée
59037 LILLE CEDEX