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<title>Detox Center - Κέντρο Φυσικής Ευεξίας</title>
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                  <P><STRONG><FONT color=#0000ff>Detox Center Μεσογείων 429 2ος, 
                  Αγία Παρασκευή, 210 6009008 </FONT></STRONG><A 
                  href="http://www.detoxcenter.gr"><STRONG><FONT 
                  color=#0000ff>www.detoxcenter.gr</FONT></STRONG></A></P>
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                     >
        <p class=MsoNormal><b><FONT color=#80ff00 size=5>Το 
                        Detoxification Program τώρα και στην 
                        Τρίπολη!!!</FONT> </b></p>
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        <p class=MsoNormal><FONT 
                        size=4 color=#0000ff>Συμπληρώστε το 
                        παρακάτω ερωτηματολόγιο, τηλεφωνήστε στο 2106009008 
                        να&nbsp;ενημερωθείτε και κερδίστε 10% στο Detoxification 
                        Program.</FONT>        
                
                  
             
                
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        <p class=MsoNormal><b>         
        </b>&nbsp;</p>
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        <p class=MsoNormal>&nbsp;</p>
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          <p class=MsoNormal><b>Εμφανίζετε κάποιο από τα παρακάτω συμπτώματα;</b></p>
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          <p class=MsoNormal><b>NAI</b></p>
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          <p class=MsoNormal><b>OXI</b></p>
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        <p class=MsoNormal><o:p>&nbsp;</o:p></p>
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      <p class=MsoNormal><span style="DISPLAY: none; mso-hide: all"><o:p>&nbsp;</o:p></span></p>
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        <p class=MsoNormal>1. σωματική κούραση χωρίς προφανή λόγο;</p>
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                     >
        <p class=MsoNormal>2. ακμή ή υπερβολική ξηρότητα στο δέρμα;</p>
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                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q2" VALUE="no"></p>
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       <tr style="mso-yfti-irow: 2">
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                     >
        <p class=MsoNormal>3. ευαισθησία στον ήλιο;</p>
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        <p class=MsoNormal><INPUT TYPE="radio" NAME="q3" VALUE="no"></p>
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       <tr style="mso-yfti-irow: 3">
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        <p class=MsoNormal>4. αδυναμία να συγκεντρωθείς (αφαιρείσαι ή
        δυσκολεύεσαι να διαβάσεις);</p>
        </td>
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                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q4" VALUE="yes"></p>
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        <p class=MsoNormal><INPUT TYPE="radio" NAME="q4" VALUE="no"></p>
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       <tr style="mso-yfti-irow: 4">
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        <p class=MsoNormal>5. σφίξιμο ή αίσθημα βάρους στο στήθος;</p>
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        <p class=MsoNormal><INPUT TYPE="radio" NAME="q5" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q5" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 5">
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>6. γρήγορο ή ακανόνιστο καρδιακό ρυθμό;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q6" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q6" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 6">
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>7. κρίση άγχους ή πανικού;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q7" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q7" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 7">
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>8. να αισθάνεσαι ότι βρίσκεσαι έκτος τόπου και
        χρόνου;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q8" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q8" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 8">
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>9. αναπνευστικό συριγμό (σφύριγμα) χωρίς να είσαι
        κρυωμένος;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q9" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q9" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 9">
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>10. αίσθημα βάρους στο κεφάλι ή στα ιγμόρεια;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q10" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q10" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 10">
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>11. συχνή ρινική καταρροή ή μπούκωμα;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q10" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q10" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 11">
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>12. ερεθισμό στο λαιμό ή ευαισθησία;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q12" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q12" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 12">
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>13. ερεθισμό στα μάτια;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q13" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q13" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 13">
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>14. θαμπή όραση;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q14" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q14" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 14">
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>15. απώλεια ή αλλαγή της αίσθησης της όσφρησης;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q15" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q15" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 15">
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>16. απώλεια ή αλλαγή της γεύσης;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q16" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q16" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 16">
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>17. μειωμένη σεξουαλική διάθεση;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q17" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q17" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 17">
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>18. ίλιγγο ή ζαλάδα;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q18" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q18" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 18">
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>19. εκνευρισμό 
                        (ευέξαπτος - η , σε ένταση) χωρίς <FONT 
                        color=#000000>σημαντικό</FONT>        
         λόγο;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q19" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q19" VALUE="no"></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 19; mso-yfti-lastrow: yes" 
                   >
        <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>20. ξαφνική απώλεια μαλλιών;</p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q20" VALUE="yes"></p>
        </td>
        <td width=25 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 18.75pt; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT TYPE="radio" NAME="q20" VALUE="no"></p>
        </td>
       </tr>
      </table>
      <table class=MsoNormalTable border=0 cellspacing=1 cellpadding=0
       align=left width="100%" style="WIDTH:
       100%;
       mso-cellspacing:
       .7pt; mso-padding-alt: 0cm 0cm 0cm 0cm; mso-table-lspace: 2.25pt; mso-table-rspace: 2.25pt; mso-table-anchor-vertical: paragraph; mso-table-anchor-horizontal: column; mso-table-left: left" 
                 >
       <tr style="mso-yfti-irow: 0; mso-yfti-firstrow: yes" 
                   >
        <td width="41%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 41%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>&nbsp;</p>
        </td>
        <td width="59%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 59%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>&nbsp;</p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 1">
        <td width="41%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 41%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><strong>Προσωπικά Στοιχεία</strong>*</p>
        </td>
        <td width="59%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 59%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>&nbsp;</p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 2">
        <td colspan=2 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; BACKGROUND: black; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><o:p>&nbsp;</o:p></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 3">
        <td width="41%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 41%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>&nbsp;</p>
        </td>
        <td width="59%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 59%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>&nbsp;</p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 4">
        <td width="41%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 41%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>Όνοματεπώνυμο:<span style="COLOR: red">*</span><o:p></o:p></p>
        </td>
        <td width="59%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 59%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT NAME="FullName" id=FullName ></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 5">
        <td width="41%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 41%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>Διεύθυνση:<o:p></o:p></p>
        </td>
        <td width="59%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 59%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT NAME="Address" id=Address ></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 6">
        <td width="41%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 41%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>Πόλη:<o:p></o:p></p>
        </td>
        <td width="59%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 59%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT NAME="City" id=City 
                       ></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 7">
        <td width="41%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 41%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>Τηλέφωνο:<span style="COLOR: red">*</span> <o:p></o:p></p>
        </td>
        <td width="59%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 59%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT NAME="PhoneNumber" id=PhoneNumber
        ></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 8">
        <td width="41%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 41%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>E-Mail:<span style="COLOR: red">*</span><o:p></o:p></p>
        </td>
        <td width="59%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 59%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><INPUT NAME="Email" id=Email 
                       ></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 9">
        <td width="41%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 41%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>Μήνυμα:</p>
        </td>
        <td width="59%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 59%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>&nbsp;</p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 10">
        <td colspan=2 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal><TEXTAREA style="WIDTH: 300px" name=Message rows=6 cols=40></TEXTAREA></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 11">
        <td width="41%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 41%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>&nbsp;</p>
        </td>
        <td width="59%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 59%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>&nbsp;</p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 12">
        <td colspan=2 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>&nbsp;<A
        href="javascript:document.ContactForm.reset()"> <INPUT TYPE="submit" ACTION="http://www.detoxcenter.gr/includes/resources/postform.php" VALUE="Αποστολή" METHOD="post" NAME="Submit"
        ><INPUT TYPE="reset" VALUE="Επαναφορά" NAME="Reset"
        id=Reset></A></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 13">
        <td width="41%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 41%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>&nbsp;</p>
        </td>
        <td width="59%" style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; WIDTH: 59%; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal>&nbsp;</p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 14">
        <td colspan=2 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p class=MsoNormal align=center style="TEXT-ALIGN: center" 
                       >* Η εταιρία
        μας δεσμεύεται ότι δεν πρόκειται να δημοσιευθούν ή χρησιμοποιηθούν <br>
        τα στοιχεία σας για οποιοδήποτε σκοπό πλην της περάτωσης του εν λόγω
        test. </p>
        </td>
       </tr>
       <tr style="HEIGHT: 3.75pt; mso-yfti-irow: 15" 
                   >
        <td colspan=2 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm; HEIGHT: 3.75pt" 
                     >
        <p class=MsoNormal><span style="FONT-SIZE:
        4pt; mso-bidi-font-size: 12.0pt" 
                       ><o:p>&nbsp;</o:p></span></p>
        </td>
       </tr>
       <tr style="mso-yfti-irow: 16; mso-yfti-lastrow: yes" 
                   >
        <td colspan=2 style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
                     >
        <p align=center style="TEXT-ALIGN: center"><b>Τα πεδία με (<span
        style="COLOR: red">*</span>) πρέπει απαραίτητα να συμπληρωθούν για την
        αποστολή της φόρμας.</b></p>
        </td>
       </tr>
      </table>
      </form>
      </td>
     </tr>
    </table>
    <p class=MsoNormal><o:p><FONT color=#ff0000>  Εαν 
            επιθυμείτε διαγραφή απαντήστε με ΔΙΑΓΡΑΦΗ σε αυτό το 
        mail.</FONT></o:p></p>
    </td>
   </tr>
  </table>
  <p class=MsoNormal><o:p></o:p></p>
  </td>
 </tr>
 <tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes">
  <td style="PADDING-RIGHT: 0cm; PADDING-LEFT: 0cm; PADDING-BOTTOM: 0cm; PADDING-TOP: 0cm" 
   >
  <p class=MsoNormal><A href="http://www.detoxcenter.gr/newsletters/index.php">Αρχική Σελίδα</A> | <A
  
      href="http://www.detoxcenter.gr/newsletters/profile.php" 
     >Εταιρικό Προφίλ</A> | <A href="http://www.detoxcenter.gr/newsletters/contact.php">Επικοινωνία</A>
  | <A href="http://www.detoxcenter.gr/newsletters/services.php">Υπηρεσίες</A> | <A href="http://www.detoxcenter.gr/newsletters/news.php">Νέα και
  Ανακοινώσεις</A> | <A href="http://www.detoxcenter.gr/newsletters/gallery.php">Photo Gallery</A> <br>
  Designed &amp; Developed by <a href="http://www.web-experts.gr"
  target="_blank">Web Experts</a>, Copyright © 2006 <A href="http://www.detoxcenter.gr/newsletters/terms.php">All
  rights reserved</A></p>
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 </tr>
</table>

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